Drug-Resistant Candida auris Cases Double in U.S. Hospitals

A deadly, drug-resistant fungal pathogen is tightening its grip on American healthcare facilities. Clinical cases of Candida auris more than doubled between 2022 and 2024, rising from 2,882 to 6,197, according to a new CDC surveillance report published July 2. The fungus, which the World Health Organization has categorized as a critical-priority pathogen, poses a particular threat to immunocompromised patients and has proven alarmingly resistant to common antifungal treatments.

What Makes Candida auris So Dangerous?

First identified in Japan in 2009 and first reported in the United States in 2016, C. auris is unlike most fungal pathogens. It can “colonize” human skin — living on the body without causing symptoms — and persist on hospital surfaces like bedrails and catheters for weeks. This combination makes it exceptionally good at spreading undetected through healthcare settings.

“When you have a colonizer that can colonize the skin and can also persist for long periods of time, for example, on bedrails, on catheters, you have a situation where you have extensive transmission,” Dr. David Perlin, chief scientific officer at the Center for Discovery and Innovation at Hackensack Meridian Health, told WTVR/CBS.

The stakes are high. For patients whose immune systems are already compromised — those with prolonged hospital stays, on mechanical ventilation, or receiving heavy antibiotic treatment — C. auris can enter the bloodstream and cause invasive infections with mortality rates ranging from 30% to 72%.

The Numbers Behind the Surge

The CDC’s latest Morbidity and Mortality Weekly Report (MMWR) Surveillance Summary, led by Dr. Jeremy A.W. Gold, paints a stark picture of the pathogen’s spread. Over the three-year period from 2022 to 2024, a total of 13,507 clinical cases were reported nationwide. Screening cases — where the fungus is detected on patients through proactive swabbing — rose even more sharply, from 6,226 in 2022 to 12,432 in 2024, totaling 27,853 screening cases.

Since 2016, the CDC has recorded 17,091 clinical cases and an additional 35,477 screening cases, according to the agency’s tracking page.

But the headline “doubling” of cases requires important context. As Forbes contributor John Drake noted, the increase partly reflects expanded testing and screening efforts, not just accelerated transmission. The most reliable metric — bloodstream infections, which unambiguously indicate invasive disease — rose approximately 60%, from 991 in 2022 to 1,586 in 2024. While still deeply concerning, this is a slower rate of increase than the overall case count suggests.

A Slowing but Still Rising Trend

There is one cautiously encouraging sign: the annual percentage increase is shrinking. Cases surged 95.9% from 2021 to 2022, then 53.7% from 2022 to 2023, and 39.9% from 2023 to 2024. The CDC suggests this deceleration may reflect a return to standard infection control practices after the COVID-19 pandemic strained healthcare systems.

“The continued increase in clinical C. auris case counts reported to CDC during 2022–2024 underscores the establishment and ongoing transmission of this pathogen,” the CDC report states.

Resistance: The Superbug Factor

What makes C. auris particularly frightening is its resistance to antifungal drugs. According to the CDC’s genomic surveillance, 91% of tested isolates were resistant to fluconazole, the most commonly used antifungal. While echinocandins — the first-line treatment — remain effective in most cases, 7% of isolates tested showed echinocandin resistance, and this resistance was found across multiple genetic clades.

“And sometimes we get drug-resistant forms where there are no more antifungal drugs that are available to treat it,” Dr. Perlin said. “And that’s why it’s being called a ‘superbug.’”

A genomic epidemiology study published in April 2026 in the CDC’s Emerging Infectious Diseases journal analyzed 1,535 isolates from 32 states and found four major clades (I, II, III, and IV) circulating in the U.S. Clade I was most common, followed by clade III and clade IV. Echinocandin resistance was identified across clades I, III, and IV, with 92% of resistant isolates carrying FKS1 hotspot mutations.

John Drake of Forbes put the challenge succinctly: “What I will be watching is resistance: nearly every isolate already defeats fluconazole, and whether the still-rare strains that also defeat the echinocandins, or every antifungal at once, stay rare will decide how dangerous Candida auris becomes.”

Who Is Most at Risk?

The data show a clear demographic pattern. Nearly 9 in 10 clinical cases occur in adults aged 45 or older, and 61% are male. The typical patient has classic risk factors: long hospital stays, mechanical ventilation, central lines, and heavy antibiotic use. Importantly, healthy individuals without these risk factors are not considered at significant risk.

Where Hospitals Are Finding It

A notable shift has occurred in where C. auris is being detected. In 2022, 56% of screening cases were found in long-term acute care hospitals (LTACHs). By 2024, that figure had inverted: 51% of screening detections were in acute care hospitals (ACHs). The CDC attributes this not to a migration of the fungus, but to hospitals increasingly screening patients at admission rather than only in long-term care settings.

What’s Being Done?

The CDC recommends strict adherence to hand hygiene, contact precautions, and the use of EPA-registered disinfectants effective against C. auris. Facilities are urged to screen high-risk patients at admission and communicate C. auris status during patient transfers. Continued investment in laboratory capacity and antifungal susceptibility testing remains critical.

The Road Ahead

The trajectory of C. auris in the United States will depend on several factors: whether echinocandin resistance remains rare or accelerates under antifungal pressure; whether infection control gains can be sustained; and whether new antifungal drugs become available to treat pan-resistant strains.

For now, the message from public health officials is clear: Candida auris has established itself in American healthcare facilities, and the fight to contain it will require sustained vigilance, better diagnostics, and a renewed commitment to the fundamentals of infection control.