Candida auris (C. auris)

There is a difference between C. auris colonization and infection. When C. auris is on someone's skin or inside of their body but causes no symptoms, it's called colonization. Colonization can last a very long time. Over time, the yeast can take over and cause infection. Someone with C. auris could spread it to others.

It doesn't take long for C. auris to spread between patients in healthcare facilities. C. auris has caused many outbreaks in the United States that have been difficult to control. Healthcare workers must be quick to detect C. auris to prevent it from spreading. Once they detect it, healthcare workers must follow recommended infection control practices.

C. auris can spread from one patient to another through direct person-to-person contact. The yeast can also spread through contaminated environmental surfaces, medical devices, or equipment. When healthcare workers touch these objects, their hands become contaminated, too. Unless they are careful, healthcare workers can then spread C. auris with their hands.

C. auris looks like other types of yeast and it is hard to tell them apart. Detecting C. auris requires special equipment that not all laboratories currently have. 

A person with C. auris may or may not experience symptoms. If they do get sick, it can happen right away or a long time after they caught C. auris. If symptoms are present, they will depend on the site of infection.

Patients with C. auris bloodstream infections often have sepsis and severe illness. Other invasive C. auris infections, such as intraabdominal candidiasis, can also occur. Invasive C. auris infections can often lead to death. C. auris can also cause wound and ear infections. 

Doctors have found C. auris in urine and respiratory specimens. C. auris can colonize (live on) the skin, nose, ears, and other body sites without causing any symptoms.

We don't know how long someone with C. auris is contagious. It may be as long as the yeast is present on or in the individual. C. auris can survive in the healthcare environment for weeks. Certain disinfectants often used in healthcare settings may not kill the yeast. Many patients in the same healthcare facility can catch C. auris within a short amount of time if proper infection control practices and disinfectants are not used. Worldwide, C. auris outbreaks have been very difficult to control. Some hospital units have had to close until the outbreak was under control.

Healthcare Workers

Healthcare workers must quickly detect C. auris if they are to prevent it from spreading. To prevent an outbreak, healthcare workers must follow recommended infection control practices, including: 

• Hand hygiene: using alcohol-based hand sanitizer or washing their hands at all the right times
• Contact precautions: wearing a gown and gloves when caring for someone suspected or known to have C. auris
• Environmental disinfection: careful cleaning of the healthcare setting and equipment
• Contact tracing: gathering information to find people who may need testing
• Public health notification: sharing important information about any cases or outbreaks early
• Public health action: acting fast to prevent further cases and stop an outbreak

Hospitals might test patients for multidrug-resistant bacteria and yeast to identify them early. Early detection helps prevent spread to other patients.

As a patient, you should:

• Tell your doctor if you were in the hospital in another facility or country 

• Take antibiotics and antifungals only as prescribed
• Expect all doctors, nurses, and other healthcare providers to wash their hands with soap and water or use an alcohol-based hand rub. They should do this before and after touching your body or tubes going into your body. If they do not, ask them to do so.
• Clean your hands often, especially:
  • before preparing or eating food
  • before and after changing wound dressings or bandages
  • after using the bathroom
  • after blowing your nose, coughing, or sneezing
• Ask questions. Understand what is being done to you, the risks and benefits.

Who should be screened for Candida auris?

• Anyone who shared a room with an individual identified with C. auris infection or colonization over the four weeks before specimen collection. Exposed individuals should be screened regardless of the use of contact precautions or length of stay.
• All patients in the same healthcare area as an individual identified with C. auris infection or colonization. Exposed individuals should be screened regardless of the use of contact precautions.
• Patients occupying a room that previously housed an individual identified with C. auris.
• Individuals with current multidrug-resistant, gram-negative bacteria who received healthcare outside of the US within the last 12 months.
• Patients transferring from a unit or facility with current transmission of C. auris or recent transmission within the last 30 days.

Notes:

• Facilities should consider adding C. auris to existing multidrug-resistant organism (MDRO) screening protocols. A composite swab of the patient’s bilateral axilla and groin can be used. For guidance on performing swab testing in-house, refer to: Guidance for Detection of Colonization of Candida auris | Candida auris | Fungal Diseases | CDC.
• All ages are at risk for C. auris infections.
• Routine screening of healthcare workers and the environment is not recommended. Exceptions include cases where epidemiological evidence links to transmission or where transmission persists despite other interventions.

Visit the DSHS Investigation Guidance webpage.

If K-12 students or children in daycare have a C. auris infection, they shouldn’t go to school until the wound is dry, clean, and bandaged. They should avoid situations that could expose the wound or get it wet, dirty, or hurt. 

Doctors have detected Candida auris in Texas.

Health Advisory: Pan-Resistant Candida auris Identified in Texas | Texas DSHS

Center for Disease Control (CDC)

• Candida auris | CDC 
• Candida auris: Drug-resistant | CDC 
• Information for Infection Preventionists | CDC 

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DSHS Related Links

• Investigation Guidance | DSHS
• Clostridioidesdifficile (C. diff)
• Carbapenem-Resistant Enterobacterales (CRE)