DRUG-RESISTANT CANDIDA SPECIES THREAT LEVEL SERIOUS

34,800 1,700 Estimated cases Estimated in hospitalized deaths in patients in 2017 2017

Dozens of Candida species—a group of fungi—cause infections, ranging from mild oral and vaginal yeast infections to severe invasive infections. Many are resistant to the antifungals used to treat them.

WHAT YOU NEED TO KNOW CASES OVER TIME ■■ Only three classes of antifungal drugs are available to Resistant Candida are commonly detected in hospitalized treat severe Candida infections: azoles, echinocandins, patients. About 7% of bloodstream infections are resistant to and amphotericin B. antifungals.

■■ Candida species commonly cause bloodstream 50,000

infections in hospitalized patients. About one in four of 44,800 44,900 these patients die. 42,000 40,200 40,000 38,700 ■■ Candida species also cause common yeast infections, 34,800 which can affect the mouth, skin, and vagina, resulting in more than 3.6 million U.S. healthcare visits each year, 30,000 and $3 billion estimated direct medical costs. ■ ■ Antibiotics used to treat bacterial infections increase 20,000 the risk of Candida infections. All data represented excludes C. auris. in Hospitalized Patients Candida in Hospitalized Estimated Cases of Drug-Resistant Estimated 10,000

0 2012 2013 2014 2015 2016 2017

40% 37% 35%

30% 27% 25%

20%

15% 14%

10% 8%

5% 5% 3% 2% 2% 1% Bloodstream Infections by Species by Infections of Candida Bloodstream Percent 0%

C. krusei C. albicans C. glabrata species C. tropicalis C. lusitaniae C. parapsilosis C. dubliniensis C. guilliermondiiOther or multiple 50,000

44,800 44,900 42,000 40,200 40,000 38,700 34,800

30,000

DRUG-RESISTANT CANDIDA SPECIES 20,000 in Hospitalized Patients Candida in Hospitalized DIFFICULT TO DETECT THREAT Cases of Drug-Resistant Estimated BLOODSTREAM10,000 INFECTIONS Candida species are well known for causing infections Candida species are a common cause of bloodstream 0 in our mouth, skin, and vagina, but these germs are infections 2012and can 2013be drug-resistant 2014 2015 and difficult 2016 to 2017treat. also a common cause of life-threatening bloodstream infections in hospitals. Most Candida infections in 40% people are caused by Candida albicans, which has very 37% low levels of drug resistance. However, other types of 35% Candida, including Candida glabrata, are frequently 30% resistant and more deadly. 27% 25% Many clinical laboratories do not have the capacity to test Candida for drug resistance, limiting the ability 20% to guide treatment and track resistance. Additionally, new, highly resistant species, such as Candida auris, are 15% 14% emerging and can also be difficult to identify. CDC’s 10% Antibiotic Resistance Laboratory Network helps clinical 8% 5% 5% labs across the United States identify emerging Candida 3% 2% 2% 1% species and test for antifungal resistance. This helps Species by Infections of Candida Bloodstream Percent lab professionals and healthcare providers rapidly and 0% correctly identify the threat and stop its spread. C. krusei C. albicans C. glabrata species C. tropicalis C. lusitaniae C. parapsilosis C. dubliniensis C. guilliermondiiOther or multiple

ONLINE RESOURCES

About Candida infections www.cdc.gov/fungal/diseases/candidiasis/index.html

About antifungal resistance www.cdc.gov/fungal/antifungal-resistance.html

This fact sheet is part of CDC’s 2019 Antibiotic Resistance Threats Report. The full report, including data sources, is available at www.cdc.gov/DrugResistance/Biggest-Threats.html. CS298822-A