Candidozyma auris in England: data up to April 2025
Published 31 July 2025
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Main points
During the latest 6 months, November 2024 to April 2025:
- there were 134 new Candidozyma auris (C. auris) cases in England reported to the UK Health Security Agency (UKHSA) [note 1]
- this was a 23% increase compared with the previous 6 months
- C. auris cases remain predominantly non-invasive (87% colonised, 12% invasive, 1% unknown specimen type) [note 2]
- 25 healthcare providers reported C. auris cases to UKHSA , of which 12 had not previously reported C. auris cases
- there were 2 declared C. auris outbreaks in NHS hospitals, both of which had been occurring since 2023
- London remains the region reporting the majority of C. auris cases (1.25 reports per 100,000 population)
Note 1: a case is defined as a person from whom there is a laboratory-confirmed isolate of C. auris (colonisation or infection).
Note 2: an invasive infection is defined as a case with one of the following reported specimen types: blood, tissue, bone, intravenous line, endotracheal aspirate or pleural fluid.
Epidemiological analyses of C. auris cases
Between January 2013 and April 2025 inclusive, a total of 800 C. auris cases (both colonisations and infections) were reported in England (Figure 1). After a peak of 136 cases in 2016, cases reduced to a low of 5 cases in 2020; however, this has since increased to 212 cases in 2024. The data for 2025 is not complete and is therefore provisional (dotted line).
Figure 1. Annual cases of C. auris by year, England 2013 to 2025
Between January 2023 and April 2025, most C. auris cases represented colonisation (84%, 366 out of 434) rather than invasive disease (13%, 56 out of 434) (Figure 2). Patients with C. auris were more likely to be male (75%, 327 out of 434) and aged over 50 (84%, 366 out of 434).
Figure 2. Monthly cases of C. auris by specimen type and month, January 2023 to April 2025
C. auris became a notifiable organism from 6 April 2025 (dotted line).
Since January 2023, most cases have been reported from the London and South-East regions (286 and 112 cases, respectively – see Table 1 and Figure 3). Seven regions have reported C. auris cases in the past 6 months.
Table 1a. Summary of C. auris cases by specimen date and region, England from January 2023 to April 2025
| Region of healthcare provider associated with case | Total healthcare providers or sites | Total reports | Percentage of total reports | Rate per 100,000 |
|---|---|---|---|---|
| North West | 6 | 8 | 1.8 | 0.11 |
| Yorkshire and Humber | 1 | 5 | 1.2 | 0.09 |
| North East | 1 | 1 | 0.2 | 0.04 |
| West Midlands | 6 | 9 | 2.1 | 0.15 |
| East Midlands | 3 | 3 | 0.7 | 0.06 |
| East of England | 1 | 3 | 0.7 | 0.05 |
| South West | 5 | 6 | 1.4 | 0.10 |
| London | 23 | 286 | 65.9 | 3.20 |
| South East | 10 | 112 | 25.8 | 1.18 |
| Unknown | 1 | 1 | 0.2 | |
| England | 57 | 434 | 100 | 0.75 |
Table 1b. Summary of C. auris cases by specimen date and region, England from 6 months to April 2025
| Region of healthcare provider associated with case | Total healthcare providers or sites | Total reports | Percentage of total reports | Rate per 100,000 |
|---|---|---|---|---|
| North West | 2 | 2 | 1.5 | 0.03 |
| Yorkshire and Humber | 1 | 1 | 0.7 | 0.02 |
| North East | 0 | 0 | 0.0 | 0.00 |
| West Midlands | 2 | 2 | 1.5 | 0.03 |
| East Midlands | 1 | 1 | 0.7 | 0.02 |
| East of England | 1 | 1 | 0.7 | 0.02 |
| South West | 0 | 0 | 0.0 | 0.00 |
| London | 14 | 112 | 83.6 | 1.25 |
| South East | 6 | 15 | 11.2 | 0.16 |
| Unknown | 0 | 0 | 0.0 | |
| England | 27 | 134 | 100 | 0.23 |
Figure 3. Map of C. auris cases by region, England 2023 to 2025
Data sources
For the purpose of this analysis, a confirmed case of C. auris is defined as the first laboratory-confirmed isolate (colonisation or infection) of C. auris identified from a patient.
Incidence data was sourced from the C. auris national linelist on 28 May 2025. The linelist collates data from the UKHSA Second Generation Surveillance System (SGSS) antimicrobial resistance (AMR) and communicable disease reporting (CDR) modules, as well as referrals to the UKHSA National Mycology Reference Laboratory.
The population denominator for the reported England and regional incidence rates were based on the mid-year resident population estimates released by the Office for National Statistics.
Caveats
The C. auris national linelist reports patients with a first detection of C. auris. Patients colonised with C. auris may remain colonised for long periods of time and the linelist does not report repeat screens or admissions of the same patient to the same or different healthcare providers.
There is likely under-ascertainment of cases. There is incomplete information on which healthcare providers screen for C. auris and the degree to which healthcare providers are screening (which patient populations, frequency). Healthcare providers reporting more cases may have a higher ascertainment rate potentially because they are screening more.
There is likely under-reporting of cases. In April 2025, C. auris became a notifiable organism and reporting became mandatory. However, not all laboratories are currently configured to report. Prior to this date there was variable reporting of isolates across the healthcare sector, including whether isolates that were not clinically significant (for example from patients who were colonised) were reported. Therefore healthcare providers reporting more cases may be better at reporting, and numbers on the C. auris national linelist may differ from figures from healthcare providers’ laboratory systems.
Ascertainment and reporting are increasing. Now that reporting is mandatory, more laboratory systems are being configured to report C. auris. Awareness of C. auris is also increasing due to reported outbreaks. Therefore, an increase in cases may relate to an increase in screening of patients and reporting by laboratories.
There may be delays to reporting and incomplete information in reports to UKHSA. For example, cases may be assigned to the healthcare provider of the reporting laboratory rather than the requesting healthcare provider for the diagnostic test of the specimen. Furthermore, cases assigned to a healthcare provider may have acquired their infection elsewhere. UKHSA does not routinely collect information on where cases are likely to have acquired their infection, for example from abroad or another healthcare provider.
There are continual efforts to validate data, including geographical assignment of cases, and the information published here is subject to change.