Hospitals on Alert: Deadly Fungus Spreads Across Europe, Luxembourg Remains Vigilant

A dangerous hospital-acquired fungus, Candida auris, is rapidly spreading in Europe, raising alarms among health authorities. While Luxembourg has not reported any cases to date, experts warn that vigilance and stronger national guidelines are essential to prevent outbreaks.

Rising Threat Across Europe
According to the European Centre for Disease Prevention and Control (ECDC), between 2013 and 2023 more than 4,000 cases of C. auris colonisation or infection were reported in the EU/EEA. Alarmingly, one-third of those cases—1,346—were detected in 2023 alone. Spain, Greece, Italy and Romania remain the hardest-hit countries, with Germany ranking fifth after recording 120 cases, 77 of them last year. France has confirmed 32 cases in the past decade, while Belgium reported 14.

The ECDC warns that these figures may only reflect “the tip of the iceberg” due to inconsistent surveillance systems across Europe. In several countries, including Greece, Italy, Romania and Spain, the fungus has already become regionally endemic, spreading so quickly that outbreaks can no longer be clearly distinguished.

Situation in Luxembourg and the Greater Region
Luxembourg remains one of the few countries in the region with no reported cases between 2013 and 2023. The country has a strong foundation in prevention, including a national reference laboratory for mycology and mandatory reporting for bloodstream infections and C. auris outbreaks. However, the ECDC notes shortcomings: Luxembourg has not yet published national guidelines for diagnosis, clinical treatment, or infection prevention and control.

By contrast, Germany has strengthened its response, introducing a mandatory reporting system for invasive cases in 2023 after several outbreaks. France and Belgium have seen fewer cases but remain under close watch.

Why C. auris Is So Concerning
Unlike other common fungal infections, C. auris is notoriously difficult to treat. Many strains are resistant to standard antifungal drugs, with echinocandins often the only remaining option. Even then, treatment failures and relapses are more frequent compared to other Candida species. Reported mortality rates from bloodstream infections range between 29% and 62%.

The fungus also poses unique challenges in hospitals. It can survive for long periods on surfaces and medical equipment, spreading mainly through direct contact rather than airborne transmission. This resilience makes it particularly dangerous in intensive care units, where vulnerable patients are most at risk.

Lessons from Past Outbreaks
Europe has already seen how quickly C. auris can become established. In countries such as Spain and Greece, it took as little as five to seven years for isolated cases to turn into regional endemic situations. These precedents highlight the urgency for Luxembourg and its neighbors to act decisively before the fungus gains a foothold.

Next Steps for Luxembourg
The ECDC recommends reinforcing early detection and infection control practices. For Luxembourg, this means using existing reporting structures effectively, expanding laboratory testing capacities, finalizing missing national guidelines, and providing concrete hospital support for isolation procedures, disinfection, and contact tracing.
For now, the risk to individuals in Luxembourg remains low. But as the rapid spread elsewhere in Europe shows, prevention and vigilance are the strongest shields against a potentially devastating hospital epidemic.

Read Full Report : Survey on the epidemiological situation, laboratory capacity and preparedness for Candidozyma (Candida) auris, 2024
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