A drug-resistant fungus that barely registered in North Carolina a year ago has spread rapidly across the state in 2026, with preliminary data showing 47 reported clinical and screening cases in just the first three months of the year. That early total already surpassed all of 2025, when the state logged 26 cases across 21 counties for the entire year.
Cases Climb Statewide Through Mid-Year
The North Carolina Division of Public Health flagged the surge in a May bulletin on hospital admission screening, noting that preliminary analysis showed cases far outpacing the prior year's count. By mid-July, the picture had shifted again: as reported by the Charlotte Observer, more than 3,100 Candida auris cases had been reported across 23 states nationwide as of July 18, including 36 in North Carolina.
Guilford County accounted for the largest share of the state's early caseload, with 26 confirmed infections recorded from January through March, according to preliminary data reported per the N.C. Department of Health and Human Services. That single county's total from the first quarter alone matched the state's entire case count for all of 2025, when Davidson County topped that year's list with just three confirmed infections.
One Rural County Posts the Highest Infection Rate
While Guilford County logged the most raw cases, Perquimans County posted the state's highest incidence rate, at 7.4 cases per 100,000 residents, the same Charlotte Observer report found. The fungus is mostly spread in health care settings and is classified as an emerging infectious disease, and it can live on skin, clothing, and surfaces for weeks to months, making it notoriously difficult to eliminate once it takes hold in a hospital or nursing home.
That persistence is part of what makes Candida auris so dangerous for vulnerable patients. The fungus can be deadly in hospitals and nursing homes, and patients who develop bloodstream infections face a 30-day mortality rate of somewhere between 30% and 40%, the outlet reported.
Treatment Options Remain Limited
Doctors treating severe infections don't have many tools to work with. Only three classes of antifungals are available to treat severe Candida auris infections, and they don't always work, Ilan Schwartz, who is affiliated with Duke University, told the Charlotte Observer.
National data suggest the trend predates this year's spike in North Carolina. The U.S. saw its first reported case of Candida auris in 2016, and cases have risen steadily since, according to the same outlet's reporting. A CDC surveillance report covering 2022 through 2024 found that most clinical cases occurred among adults aged 45 and older, accounting for 87.8% of cases, and that infections affected men more often, at 61.0%, according to the CDC's Morbidity and Mortality Weekly Report. Separate CDC tracking data put the nationwide total at 6,304 clinical cases in 2024 alone, noting that cases have increased since 2016.
For now, North Carolina's health department continues to monitor hospital admissions and screening data as the state works to contain further spread, particularly in long-term care facilities where the fungus has proven hardest to root out.
