Cause: Candida auris is an emerging, often multidrug resistant, yeast first identified in Japan in 2009. It can cause invasive healthcare-associated infections with high mortality.
Illness and treatment: Healthy people usually do not get infections due to C. auris. Common infections associated with C. auris include blood stream and wound. Mortality associated with C. auris infections is estimated to be 30-60%, however, most cases have other serious comorbidities which may cause or contribute to death. C. auris may also colonize the skin and other body sites. Both infected and colonized patients can transmit the organism to others via healthcare workers hands or contaminated fomites. For treatment guidance for invasive infections, consultation with an infectious disease specialist is highly recommended. CDC does not recommend treatment of C. auris identified from non-invasive sites (such as respiratory tract, urine, and skin) when there is no evidence of infection.
Sources: Healthcare personnel's hands and other contaminated items in healthcare settings are the most frequent sources for spread of C. auris.
Additional Risks: In the United States, C. auris has been predominantly identified among patients with extensive exposure to ventilator units at skilled nursing facilities and long-term acute care hospitals.
Prevention: The best ways to prevent colonization and infections with C. auris are through meticulous adherence to routine infection control precautions in healthcare settings including:
- Hand hygiene
- Placing patients infected with C. auris on appropriate transmission-based precautions
- Minimizing the use of invasive devices such as central venous lines, urinary catheters and ventilators
- Using antibiotics only when necessary and for the minimum time required
Recent Washington trends: C. auris was first reported in Washington in 2023 and since January 2024 has been detected in patients in several healthcare facilities and counties. As has occurred in many US states, C. auris may continue to spread among highly vulnerable patients in high acuity long term care facilities (for example, sites caring for patients needing long term ventilator support). Facilities can prevent transmission by strengthening infection prevention programs and auditing practices.
Information for Laboratories: Candida auris can be mistaken for other Candida species, such as Candida haemulonii, Candida duobushaemulonii, Rhodotorula glutinis, Candida intermedia, Candida sake, Saccharomyces kluyveri, Candida catenulate, Candida famata, Candida guilliermondii, Candida lusitaniae, and Candida parapsilosis, by certain yeast identification assays, such as VITEK 2 YST, API 20C, BD Phoenix yeast identification system, and MicroScan. Laboratories should know the limitations of their yeast identification system by reviewing Identification of Candida auris to avoid mistakenly identifying C. auris as another fungal species. Commercial labs may serve as Candida sentinel labs and submit to PHL all Candida species except albicans. For information about sentinel labs, please contact the Washington Antibiotic Resistance Lab Network at ARLN@doh.wa.gov
Purpose of Reporting and Surveillance
- To increase awareness of Candida auris by public health and healthcare professionals.
- To promote appropriate infection control interventions to prevent transmission of Candida auris between patients in healthcare facilities and between healthcare facilities.
- To rapidly identify Candida auris and prevent or eliminate sources or sites of ongoing transmission within Washington.
- To better characterize the epidemiology of Candida auris infections in Washington to guide response.
Legal Reporting Requirements
1. Health care providers and Health care facilities: notifiable to the local health jurisdiction within 24 hours.
2. Laboratories: lab report to the local health jurisdiction (LHJ) within 24 hours; submission required to PHL – isolate or if no isolate specimen associated with positive result, within 2 business days.
- Positive result by any method including, but not limited to, culture, nucleic acid detection (NAT or NAAT), or whole genome sequencing;
- Isolates should be accompanied by a Public Health Laboratories (PHL) Antibiotic Resistance Lab Network (ARLN) Requisition Form. See ARLN Test Menu and Specimen Collection and Submission Instructions for details on isolate submission.
3. Local health jurisdictions: notifiable to Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary of information required within 21 days.
Resources
Reporting
- Candida auris Case Definition (PDF)
- Candida auris Reporting Form (PDF)
- Candida auris Guideline (PDF)
For Patients
Infection Prevention
- Targeted Multidrug-resistant Organism Prevention and Response Toolkit
- Infection Control Actions for Prevention and Response | CDC
- Candida auris: Working Together to Prevent Spread in your Healthcare Facility | YouTube
- Inter-Facility Infection Control Transfer Form (PDF) | CDC
- Notification of Multidrug Resistant Organism Cluster (WORD)
- What to do if you Identify a Targeted Multidrug Resistant Organism in your Facility (PDF)
- Multi-Drug Resistant Organism Quick Reference Guide and Job Aid Combined (PDF)
Screening Patients
- Screening FAQs: Verbal Consent Example (WORD) | CDC
- Screening FAQs: Verbal Consent Example (WORD) (Spanish) | CDC
Laboratories
Notifiable Conditions Directory
2022 Communicable Disease Report (PDF)
LHJ CD Epi Investigator Manual (PDF)