Nosocomial Outbreaks of Invasive Candidiasis: A Literature Review and Synthesis of Epidemiological Data

Introduction. Frequent hospitalization of immunocompromised patients, the use of invasive devices, and antibacterial therapy contribute to the nosocomial spread of invasive candidiasis pathogens, including hospital outbreaks.

Objective. To characterize, based on published data, the epidemiological features of healthcare-associated outbreaks of invasive candidiasis caused by different yeast species and the measures used for their control.

Materials and methods. We analyzed data from online databases (Outbreak Database, PubMed, eLibrary) using the keywords “Candida,” “outbreak,” “nosocomial,” and “healthcare-associated infections”.

Results. A total of 82 outbreaks reported between 1977 and 2025 were included. The etiological profile of published outbreaks shifted from the predominance of C. albicans to the dominance of C. parapsilosis and, since 2016, C. auris. Outbreaks caused by C. auris and C. parapsilosis were characterized by prolonged duration and a wide range of contributing factors. Outbreaks caused by fluconazole-resistant strains were associated with longer duration and higher mortality. The main transmission factors included healthcare workers’ hands and parenteral nutrition solutions. The most effective control measures included epidemiological surveillance, hand hygiene monitoring, thorough environmental decontamination, isolation and restriction measures, and specialized strategies for C. auris.

Conclusion. Healthcare-associated outbreaks of invasive candidiasis caused by different yeast species differ in duration, mortality, and transmission patterns depending on the pathogen species and their susceptibility to antifungal agents. Their prevention and control depend on timely detection of colonized and infected patients, species-level identification of the pathogen, and appropriate selection of infection control measures depending on the pathogen species.

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