Rapid risk assessment: Candida auris in healthcare settings – Europe

Risk assessment
23 Apr 2018

 European Centre for Disease Prevention and Control. Candida auris in healthcare settings – Europe – first update, 23 April 2018. Stockholm: ECDC; 2018.

This rapid risk assessment update appraises the risk for spread of C. auris in hospitals in the European Union and European Economic Area (EU/EEA) countries, considering the newly available information from the ECDC survey on the epidemiological situation as well as laboratory capacity and preparedness for C. auris in EU/EEA countries.

Executive summary

Due to its propensity to cause outbreaks and its antifungal resistance, Candida auris poses a risk for patients in healthcare facilities in Europe. Difficulties with laboratory identification, and lack of awareness of this new Candida species might result in transmission and outbreaks remaining unnoticed.

Candida auris is a newly emerging yeast that was first described in 2009 and has subsequently been associated with invasive infections and outbreaks in healthcare settings worldwide. There is a need for raising awareness in European healthcare facilities, for them to adapt their laboratory testing strategies and implement enhanced control measures early enough to prevent further hospital outbreaks.

This yeast can cause invasive infections in severely compromised patients, and most isolates are resistant to fluconazole, a commonly used antifungal to treat infections caused by Candida species. Resistance to other antifungal agents has also been reported, and multidrug-resistant C. auris isolates with resistance to all three main classes of antifungals have been described.

Unlike other Candida species, C. auris seems to have a high propensity for patient-to-patient transmission in healthcare settings, possibly related to environmental contamination, or transient person or device colonisation. Furthermore, commercially available laboratory tests used by clinical laboratories might fail to identify it.

ECDC’s risk assessment outlines options to prevent the transmission of C. auris in healthcare settings through improved laboratory detection, standard infection control measures, precautions related to inter-hospital and cross-border transmission, and improved preparedness of EU/EEA countries.