Latest data from UK Health Security Agency (UKHSA) show that bloodstream infections caused by yeast rose by 4% in 2024, compared to 2023 (from 2,170 to 2,247 reports).
In 2024 the rate of bloodstream infections due to yeast across England was 3.9 per 100,000 population, compared to 3.8 in 2023.
Bloodstream infections caused by yeast are typically acquired in a hospital setting from the patient’s own flora (yeasts found naturally on our skin or in our intestinal tracts). The prolonged use of broad-spectrum antibiotics in hospital settings can also play a role because they suppress the patients’ natural bacterial flora allowing yeasts to overgrow in the intestinal tract and potentially enter the bloodstream through the gut wall. Patients with weakened immune systems are also more vulnerable to fungal infections, particularly those being treated for cancers, and people whose treatment involves devices inside their body.
The most common species of yeast causing infection was Candida albicans (C. albicans), followed by Nakaseomyces glabratus (previously known as Candida glabrata) and Candida parapsilosis (C. parapsilosis) respectively. Rates of bloodstream infection due to N. glabratus were highest in eldest age groups, while rates due to C. albicans and C. parapsilosis were highest in the youngest age groups.
Data for 2024 also show rates are higher in more deprived populations of the country than the least deprived (5.0 and 3.2 per 100,000 population respectively). UKHSA is working with partners to understand the reasons for these differences.
Overall, resistance to antifungal drugs has remained relatively stable and treatments remain largely effective. However, an increase in Candidozyma auris (previously known as Candida.auris), an emerging pathogen of global clinical concern which can develop resistance to many available treatments, highlights the importance of remaining vigilant to increasing rates of yeast infections.
Data from UKHSA’s Health Protection Report show that 637 C. auris cases (including infections and colonisations) were reported across England between January 2013 and December 2024, of which 178 were reported in 2024. Previously rarely detected in England, C. auris has been emerging over the last decade, with a notable resurgence following the lifting of travel restrictions after the COVID-19 pandemic period.
To support healthcare professionals with outbreaks of C. auris, UKHSA recently published revised guidance on managing outbreaks. To strengthen surveillance and help inform the public health response, C. auris is now a notifiable disease, meaning laboratories that test human samples in England will be required to report C. auris cases to UKHSA.
Professor Andy Borman, Head of the Mycology Reference Laboratory, UKHSA, said:
Our surveillance shows that serious fungal infections are having an increasing impact on public health. UKHSA is working with the NHS to explore the reasons behind the rise in serious yeast infections, but factors such as an increase in people who are immunocompromised and the number of people receiving complex surgeries may be playing a part.
Thankfully, the antifungal drugs we use are still effective against these infections. However, this could change and these infections could become harder to treat in the future. The rise of drug-resistant C. auris in hospitals in England means we must remain vigilant and continue our work to enhance infection prevention and control efforts and to maintain patient safety.
Unlike bacterial infections, fungal infections did not decline during the pandemic, likely due to pressures on NHS services and the fact that severe COVID infections predisposed hospitalised patients to several types of invasive fungal infections. The rate of bloodstream infections has continued to rise since 2020.
Existing guidelines emphasise the importance of rapid fungal diagnostics to manage these types of infections, and the development of new tools to improve surveillance and patient outcomes.
