The fungus and pathogen Candida auris is spreading rapidly in Germany. The fungus is immune to various medications. Health authorities are alarmed and researchers are urging a general reporting requirement.

In 2023, Candida auris was detected 77 times nationwide – that was six times more common than in previous years, according to the evaluation by the National Reference Center for Invasive Fungal Infections (NRZMyk), based in Jena. The yeast fungus, which was only discovered in 2009, can be transmitted between people and is immune to various medications.

“We are currently assuming with a high degree of certainty that this is a real increase in the number of cases and not a ‘better recording’, said Oliver Kurzai from the Institute for Hygiene and Microbiology at the University of Würzburg, who is also head of the NRZMyk. So far, the reference center is not aware of any deaths in Germany that can be directly attributed to an infection with the yeast fungus.

Nevertheless, the fungus is dangerous, especially for people who are previously ill or have a weakened immune system. According to Kurzai, in addition to bloodstream infections (“fungal sepsis”), infections of prostheses and foreign materials in the body caused by Candida auris are particularly threatening and difficult to treat, such as infections of joint prostheses.

The research team led by Alexander M. Aldejohann from the University of Würzburg published the increase in the number of cases in Germany in the Epidemiological Bulletin of the Robert Koch Institute. Only some of these cases were recorded as part of the reporting requirement introduced in 2023, as this only applies to certain infections.

A further increase in the number of cases in Germany must be assumed to be likely; a general reporting requirement for every laboratory finding could slow down the spread of the fungus. It also recommends comprehensive testing for Candida auris.

The fungus usually does not affect healthy people. It can become a problem in hospitals and care facilities, especially in intensive care units. Transmission occurs via smear infections.

The pathogen does not spread through the air, such as the coronavirus. “If Candida auris gets into your bloodstream, there is a risk of blood poisoning, which is fatal in just over half of all cases,” the researchers write.

Sepsis manifests itself, among other things

Sepsis is a medical emergency and must be treated immediately. Every hour without medical care increases the risk of death.

The symptoms after an infection with Candida auris vary. According to the portal “Netdoktor.de”, they can resemble complaints that are associated with infections with other fungi or bacteria. This is what the fungus can do, among other things

trigger.

In 58 of 77 cases registered in Germany last year, the patients were infected with the fungus. According to the scientists, infection occurred in 13 other cases. In 6 cases the status is unclear. Of the colonized patients or those with unclear infection status, 5 would have developed an invasive infection later on. The most common infections were therefore

The increase in Candida auris is primarily due to three outbreaks, it is said. “The enormous increase in 2023 surprised us. Outbreaks in hospitals are particularly crucial here. If these are not recognized early and combated adequately, they will be very difficult to get under control later,” explained Aldejohann.

The yeast Candida auris, which was only discovered in 2009, has quickly spread internationally. From the beginning, the extremely stubborn pathogen was resistant to some antimycotics – drugs that combat fungal infections – and some disinfectants. According to “Netdoktor.de”, doctors would therefore have to combine several active ingredients against fungal diseases in high doses.

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