Center for Improvement in Healthcare Quality Newsletter
July 2022

CIHQ-ARS Blog

Candida Auris

By: Robin Ruthford
Have you experienced Candida auris (C. auris) in your organization? Were you unsure who to contact or what to do? This article provides information on C. auris and the Center for Disease Control’s (CDC) recommendations for infection control measures.
What is Candida auris?
Candida auris is a type of yeast (fungus) that can cause serious illness in people in healthcare facilities. It was first identified in Japan in 2009, and has now been reported in over 35 countries, including the United States. The Center for Disease Control (CDC) suggests that it presents a serious global health threat because it can cause serious illness, including bloodstream infections, wound infections, and ear infections. It can also colonize on the skin, nose, ears, and other body sites without causing any symptoms. Patients who are colonized with C. auris are at risk for developing an invasive infection.
Why is Candida auris a challenge in your organization?
Although C. auris is rare in the United States, approximately 1 in 3 people with an invasive C. auris infection (infection that has entered the bloodstream and spread throughout the body) die. According to the CDC, C. auris is often resistant to more than one of the three most common antifungal classes (azoles, polyenes and echinocandins), and in some cases may be resistant to all three classes. In addition, it is challenging to identify as special laboratory tests are needed to differentiate it from other yeasts. C. auris can also spread in healthcare settings through contact with contaminated environmental surfaces, medical devices, equipment, or from person to person.
What should I do if there is C. auris in my facility?
The CDC recommends the following:
  • Check the CDC website for the most up-to-date guidance on identifying and managing C. auris at www.cdc.gov/fungal/candida-auris.
  • Report possible or confirmed C. auris test results immediately to your public health department.
  • Screen contacts of case-patients to identify patients with C. auris colonization. Use the same infection control measures for patients found to be colonized.
  • When a patient is being transferred from your facility, clearly communicate the patient’s C. auris status.
The CDC also recommends the following infection control measures for patients who are infected or colonized with C. auris:
  • Place patients in Transmission-Based Precautions for their entire hospital stay.
  • Place patients in a single room if possible, or cohort patients with C. auris in non-single occupancy room.
  • Make sure PPE, including gowns and gloves are accessible and used appropriately.
  • Reinforce hand hygiene. Alcohol-based hand sanitizer is effective against C. auris.
  • Clean the environment and equipment using a disinfectant with an Environmental Protection Agency claim for C. auris (List P) or, if not available, for Clostridioides difficile (List K).
In summary, although C. auris is rare in the United States, it is an emerging pathogen that can pose a serious health threat. It is often misidentified and can be difficult to treat. Following the CDC’s recommendations for infection control practices is important in managing a patient with C. auris.
References
Bradley SF. Candida auris Infection. JAMA. 2019;322(15):1526. doi:10.1001/jama.2019.13857
Center for Disease Control and Prevention, (n.d.). General Information about Candida auris. https://www.cdc.gov/fungal/candida-auris/candida-auris-qanda.html.
Center for Disease Control and Prevention, (n.d.). Information for Infection Preventionist. https://www.cdc.gov/fungal/candida-auris/fact-sheets/cdc-message-infection-experts.html
Center for Disease Control and Prevention, (n.d.). Information for Laboratories and Health Professionals. https://www.cdc.gov/fungal/candida-auris/health-professionals.html
Center for Disease Control and Prevention, (n.d.). Infection Prevention and Control for Candida auris. https://www.cdc.gov/fungal/candida-auris/c-auris-infection-control.html
Sabino, R., Veríssimo, C., Pereira, Á. A., & Antunes, F. (2020). Candida auris, an Agent of Hospital-Associated Outbreaks: Which Challenging Issues Do We Need to Have in Mind? Microorganisms, 8(2), 181. https://doi.org/10.3390/microorganisms8020181
Sikora A, Zahra F. Candida Auris. [Updated 2021 Sep 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563297
Spivak, E. S., & Hanson, K. E. (2018). Candida auris: an Emerging Fungal Pathogen. Journal of clinical microbiology, 56(2), e01588-17. https://doi.org/10.1128/JCM.01588-17
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