Candida auris: Facts & Prevention

What is Candida auris?

Candida auris (C. auris) is a type of yeast and is an emerging fungal pathogen that can cause infections anywhere in the body, including severe invasive infections such as bloodstream infections. It was first identified in Japan in 2009, and infections have now been reported on every populated continent, including in North America and the United States. The risk to the general public and otherwise healthy people, including healthcare workers, is extremely low.^1,2 In hospitalized patients, it can cause severe illness. C. auris can colonize the skin and has been isolated from multiple infection sites in the body. There are limited antifungal drugs available to treat Candida infections and like other “superbugs,” C. auris is often resistant to one or more of these antimicrobial agents. Additionally challenging, C. auris is difficult to identify with standard laboratory testing.³ Healthcare transmission is responsible for most, if not all, cases.^1,2

C. auris Symptoms

Candida auris infection symptoms can vary greatly and are specific to the infected body site. The most common symptoms of invasive Candida infection are fever and chills that do not improve after antibiotic treatment for a suspected bacterial infection.⁴

Incubation Period and Duration of Illness

The incubation period of C. auris from exposure to infection is currently unknown because this pathogen can colonize the skin for months or years without entering the body and causing an infection and symptoms. Duration of illness is multifactorial — depending on the body site infected and the patient's baseline health.

Who Is At Risk?

Candida auris primarily affects patients in healthcare settings who are vulnerable due to preexisting health conditions or the need for invasive medical devices. Risk factors include being on mechanical ventilation machines, having a tracheostomy, presence of invasive devices such as central lines, prolonged or multiple stays in a healthcare facility, particularly long-term care, and recent use of antimicrobials.⁶ Patients at highest risk of an invasive Candida infection are usually already ill from other medical conditions or have spent a prolonged time in healthcare settings — particularly long-term acute care hospitals (LTACHS) or ventilator-capable skilled nursing facilities (vSNFs) — and have lines and tubes that go into their body (such as breathing tubes, feeding tubes and central venous catheters), making them more vulnerable.

Since 2016 when the first U.S. case of C. auris was diagnosed and confirmed, there has been a steady increase in the number of cases. The disease burden has grown annually from 51 confirmed cases in 2016 to 4,514 new confirmed cases in 2023.2 A 95% increase in clinical cases was observed between 2020 and 2021.¹ As this pathogen is monitored, it is important to also continue surveillance of drug-resistant C. auris strains. Between 2019 and 2021, the number of U.S. drug-resistant C. auris cases increased by threefold from the previous year.¹

Direct and Indirect Contact

As the pathogen that colonizes the skin, C. auris can spread person-to-person via direct contact from either a colonized or infected individual.⁴ One of the biggest issues with C. auris is that infected patients shed the pathogen from their skin into the immediate environment where surfaces become contaminated. Shared or portable medical equipment has been identified as an important source for disease transmission.

Hand Hygiene

It is important to practice proper and frequent hand hygiene techniques when interacting with C. auris patients. Use hand sanitizer unless hands are visibly soiled. Follow facility hand hygiene policy.

Cleaning and Disinfecting Surfaces

The CDC recommends use of a hospital-grade disinfectant that is registered with the Environmental Protection Agency (EPA) and is effective against C. auris (see EPA List P).¹⁰ If a product with an EPA claim is not accessible or otherwise suitable, the CDC recommends using a sporicidal disinfectant (see EPA List K).¹¹ Disinfectants with an EPA claim for C. difficile have been used effectively against C. auris. It is important to follow the directions for use, including applying the product for the stated contact time. Increased attention to detail and monitoring for compliance should include:

• Surfaces in patient rooms, with special attention to high-touch surfaces and the bed-space area
• Surfaces in areas where patients receive care (e.g., radiology, physical therapy, etc.)
• Mobile and shared equipment (e.g., ventilators, vital signs machines, physical therapy equipment, thermometer probes)⁵

Isolation Precautions

Identify and isolate patients that test positive for C. auris. Wear gloves and gowns in C. auris isolation rooms when delivering care.⁶ Clean and disinfect the patient’s room with appropriate disinfectants often. Wash hands often and especially before leaving the patient’s room.⁶

A number of Clorox Healthcare cleaner disinfectants can be used to effectively manage Candida auris on environmental surfaces and equipment in healthcare settings. The contact time, or wet time, is the time that the surface must remain visibly wet for the disinfectant to be effective against the specific pathogen. Always follow the label’s directions for use when cleaning and disinfecting.

PRODUCT	PRODUCT IMAGE	EPA REG. NO.	C. AURIS CONTACT TIME (EPA LIST P)	C. DIFF CONTACT TIME (EPA LIST K)
Clorox Healthcare Bleach Germicidal Wipes 6″ x 5″ Clinical Wipes, 6/150 ct., Item No. 30577 6.75″ x 9″ Multipurpose Wipes, 6/70 ct., Item No. 35309 6.75″ x 9″ Softpack, 9/100 ct., Item No. 32621 6.75″ x 9″ Individual Wipes, 6/50 ct., Item No. 31424 12″ x 12″ Terminal Wipes, 2/110 ct., Item No. 30358 12″ x 12″ Terminal Wipes Refill, 2/110 ct., Item No. 30359		67619-12	3 min	3 min
Clorox Healthcare Bleach Germicidal Cleaner 6/32 fl. oz. Spray, Item No. 30577 6/32 fl. oz. Pull-Top, Item No. 68832 4/128 fl. oz. Refill, Item No. 68978		56329-7	3 min	3 min
Clorox Healthcare Spore10 Defense Cleaner Disinfectant 4/128 fl. oz. for Total 360 Devices, Item No. 32122 4/128 fl. oz. Ready-to-use, Item No. 32409		67619-40	3 min	5 min
Clorox Healthcare Hydrogen Peroxide Cleaner Disinfectant Liquids 9/32 fl. oz. Spray, Item No. 30828 6/32 fl. oz. Pull-Top, Item No. 31444 4/128 fl. oz. Refill, Item No. 30829		67619-24	2 min	—
Clorox Healthcare Hydrogen Peroxide Cleaner Disinfectant Wipes 6.75″ x 9″ Multipurpose Wipes, 6/95 ct., Item No. 30824 6.75″ x 5.75″ Clinical Wipes, 6/155 ct., Item No. 30825 12″ x 11″ Terminal Wipes, 2/185 ct. bucket, Item No. 30826 12″ x 11″ Terminal Wipes, 2/185 ct. refill pouch, Item No. 30827		67619-25	2 min	—
Clorox Healthcare Fuzion Cleaner Disinfectant 9/32 fl. oz. Spray, Item No. 31478		67619-30	—	90 sec
Dispatch Hospital Cleaner Disinfectant Towels 6.75″ x 8″ Canister, 8/150 ct., Item No. 69150		56392-8	—	3 min
Clorox Germicidal Bleach 3/121 fl. oz. Bottle, Item No. 30966		67619-32	—	3 min

Educational Resources

• Candida auris Pathogen Education Sheet
• C. auris Cleaning and Disinfection Toolkit
• What Is Candida auris (C. auris)?
• Candida auris: When to Screen and When to Identify Species

Educational Courses (CE Credits Available)

• Candida auris: An Emerging Threat
• Candida auris: An Emerging Threat in Long-Term Care

Clinical Evidence

• Effectiveness of Disinfectants Against Candida auris and Other Candida Species – Clinical Study

Blog Posts

• Candida auris – An Emerging and Difficult Threat
• Fungal Pathogens with Sticking Sticking Power
• The Problem(s) with Candida auris
• The COVID-19 Pandemic’s Impact on Two Urgent-threat Pathogens: Candida auris and Clostridioides difficile