A hospital fungus on the rise as scientists warn of a growing global threat

A drug-resistant Candida auris fungus is becoming more dangerous and more widespread, according to scientists who warn that the hospital-acquired infection is adapting in ways that make it harder to treat and easier to spread.

The yeast, which can cause severe and often fatal infections in people with weakened immune systems, has now been identified in more than 60 countries across six continents. Researchers say its growing resistance to antifungal drugs, combined with its ability to cling to human skin and hospital surfaces, poses a serious challenge for health services worldwide.

Candida auris was first detected in 2009 in Japan, where it was isolated from a patient’s ear canal. Within a few years it had appeared in hospitals across Asia, Europe and the Americas, prompting health authorities in countries such as India to label it a major public health concern by 2014.

What sets the fungus apart, scientists say, is its unusual biology. Unlike many other yeasts, drug-resistant Candida auris can shift its growth pattern, allowing it to spread more aggressively. It also produces specialised cell wall proteins that enable it to adhere tightly to human skin.

“Skin colonisation by C auris is a significant medical concern because colonised patients may facilitate inter- and intra-hospital transmission,”

the researchers note, warning that patients may unknowingly carry the fungus from ward to ward.

The organism is further protected by microscopic pumps embedded in its cell membrane, which actively expel antifungal medicines before they can take effect. It can also form dense, slimy biofilms on medical equipment and surfaces, creating an additional barrier that drugs struggle to penetrate.

Diagnosis remains another weak point. The review warns that infections are often misidentified in routine laboratory tests, delaying appropriate treatment and increasing the risk of outbreaks. “Misidentification leads to delays in starting appropriate antifungal therapy,” the authors write.

Fungal infections already affect millions of people each year and are associated with high mortality rates even when treatment is available. Against that backdrop, the growing spread of drug-resistant Candida auris has heightened concern among clinicians and microbiologists.

The researchers argue that tackling the threat will require better surveillance, particularly in countries with limited healthcare resources, alongside improved diagnostic tools. They also point to cautious optimism, noting that several new antifungal drugs are currently in clinical trials and could become available in the near future.

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