Drug-Resistant Candida Species

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DRUG-RESISTANT CANDIDA SPECIES THREAT LEVEL SERIOUS 34,800 Estimated cases in hospitalized patients in 2017 1,700 Estimated deaths in 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 ■ Only three classes of antifungal drugs are available to treat severe Candida infections: azoles, echinocandins, and amphotericin B. ■ Candida species commonly cause bloodstream infections in hospitalized patients. About one in four of these patients die. ■ Candida species also cause common yeast infections, which can affect the mouth, skin, and vagina, resulting in more than 3.6 million U.S.

healthcare visits each year, and $3 billion estimated direct medical costs. ■ Antibiotics used to treat bacterial infections increase the risk of Candida infections. All data represented excludes C. auris. CASES OVER TIME Resistant Candida are commonly detected in hospitalized patients. About 7% of bloodstream infections are resistant to antifungals. 30,000 20,000 10,000 0 40,000 50,000 44,800 44,900 42,000 40,200 38,700 34,800 Estimated Cases of Drug-Resistant Candida in Hospitalized Patients 2012 2013 2014 2015 2016 2017

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DRUG-RESISTANT CANDIDA SPECIES DIFFICULT TO DETECT THREAT Candida species are well known for causing infections in our mouth, skin, and vagina, but these germs are also a common cause of life-threatening bloodstream infections in hospitals. Most Candida infections in people are caused by Candida albicans, which has very low levels of drug resistance. However, other types of Candida, including Candida glabrata, are frequently resistant and more deadly. Many clinical laboratories do not have the capacity to test Candida for drug resistance, limiting the ability to guide treatment and track resistance. Additionally, new, highly resistant species, such as Candida auris, are emerging and can also be difficult to identify. CDC's Antibiotic Resistance

Laboratory Network helps clinical labs across the United States identify emerging Candida species and test for antifungal resistance. This helps lab professionals and healthcare providers rapidly and correctly identify the threat and stop its spread. BLOODSTREAM INFECTIONS Candida species are a common cause of bloodstream infections and can be drug-resistant and difficult to treat. 30,000 20,000 10,000 0 37% 27% 14% 8% 3% 2% 2% 1% 5% Estimated Cases of Dr Candida in Hospitaliz Percent of Candida Bloodstream Infections by Species 2012 C. albicans C. glabrata C. parapsilosis C. tropicalis C. dubliniensis C. krusei C. lusitaniae C. guilliermondii Other or multiple species 2013 2014 2015 2016 2017 0% 5% 10% 15% 20% 25% 30% 35% 40% 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