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CDC

Antimicrobial Resistance Lab Network

Candida auris Antimicrobial Resistance

Number of C. auris Isolates Tested

24,301

2017 - 2024

Percent of C. auris Specimens Resistant to at Least One Echinocandin

1.19%

289/24,301 where anidulafungin or micafungin ≥ 4 µg/mL

Percent of C. auris Specimens with Mutations in FKS1 Hotspots

2.56%

124/4,847 where FKS1 mutations were identified, 2018 - 2022

AR Lab Network Priority Area

Candida auris Antimicrobial Resistance

Candida auris (Candidozyma auris) is a yeast which can cause illnesses ranging from superficial skin infections or severe invasive infections typically in very sick patients. C. auris spreads easily in healthcare facilities and requires adherence to recommended infection control practices.

C. auris is almost always resistant to at least one class of antifungal drugs, meaning the fungus has developed the ability to survive even when treated with the antifungal drug. Echinocandins are the current first line therapy for C. auris because resistance to azoles, one of the most frequently used medications for candida infections, is common. Some cases of C. auris are pan-resistant meaning they are resistant to all three main antifungal classes commonly used to treat candida infections. CDC monitors C. auris cases and the rates of resistance, including first-line treatment echinocandins, to prevent spread and guide appropriate treatment decisions.

The AR Lab Network routinely performs Candida identification and Antifungal Susceptibility Testing (AFST) to identify antimicrobial resistant C. auris. The following 4 antifungal drugs are a part of this testing and have tentative minimum inhibitory concentration (MIC) breakpoints established by CDC, which can be used to determine drug resistance*.

Azoles

  • Fluconazole (MIC ≥32 µg/mL)

Echinocandins

  • Anidulafungin (MIC ≥4 µg/mL)
  • Micafungin (MIC ≥4 µg/mL)

Polyenes

  • Amphotericin B (MIC ≥2 µg/mL)

AR Lab Network data are presented in both aggregated and year-to-year formats. The AR Lab Network is not a traditional surveillance system; changes in year-to-year antimicrobial resistance rates may also be reflective of year-to-year changes in testing priorities, methods, or volume, jurisdictional reporting criteria, and other factors. Year classification is defined by specimen collection date.

*Neither the Food and Drug Administration nor the Clinical and Laboratory Standards Institute have established breakpoints for Candida auris. The breakpoints presented here are not based on the outcome of human clinical therapeutic trials.

Data Source
AR Lab Network
Years Included
2017 - 2024
Resources

Antimicrobial Resistance

Antimicrobial resistance means that the C. auris isolate had a minimum inhibitory concentration (MIC) greater than the CDC tentative breakpoints. Increases in resistance can be driven by several factors, including antifungal use and spread of resistant strains among patients.

Antimicrobial Resistance Detected in C. auris, By Year(s)

Select data visualizations using the drop down above to view a specific year’s data. This graph shows the proportion of isolates resistant to each of the evaluated antifungals. Isolates can be resistant to more than one drug and can be counted in more than one category.

Susceptibility to Antifungal drugs, by drug

This table shows the percentage of C. auris isolates that had a resistant or an intermediate interpretation for the antifungal tested.

Antifungal susceptibility testing results were interpreted using the CDC tentative minimum inhibitory concentration breakpoints for C. auris.

Isolates can be resistant to more than one antifungal. Isolates resistant to all three antifungal classes are pan-resistant.

Loading susceptibility data…

Geographic Locations

Rates of antimicrobial resistance vary by location.

Antimicrobial Resistance in C. auris, By State and Year(s)

Select data visualizations using the tab above to view a specific year’s data. This graph shows the proportion of isolates resistant to each of the evaluated antifungals. Isolates can be resistant to more than one drug and can be counted in more than one category. Data from states with fewer than 5 isolates tested are not shown.

Antimicrobial Resistance in C. auris, Region and Year(s)

Select data visualizations using the tab above to view a specific antifungal and year’s data.

Footnotes

  • The AR Lab Network is not designed to be a traditional surveillance system. Isolates tested are a convenience sample and include clinical, surveillance, and outbreak specimens. Within each state, isolate submissions and testing are determined by state priorities and reporting regulations.
  • A map of the AR Lab Network regions is available at https://www.cdc.gov/antimicrobial-resistance-laboratory-networks/php/about/domestic.html.
  • Due to Covid-19 related disruptions, data for 2021 did not undergo annual data validation with participating labs.
  • Suggested citation: CDC Antibiotic Resistance & Patient Safety Portal (AR&PSP) AR Lab Network Data. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC. https://arpsp.cdc.gov/.
  • C. auris whole genome sequences with detected FKS1 mutations are defined by the presence of amino acid substitutions in hotspot 1 (F635 to P643), hotspot 2 (D1350 to L1357), and/or position W691 in hotspot 3 of this gene. These mutations were identified using the bioinformatic methods outlined in the technical appendix.
  • Data displayed are updated as of January 2026. Given the structure of the AR Lab Network and its testing strategies, supplementary testing and the availability of improved methods and additional data may result in changes or corrections to data reported on PSP.