Intro
Candida auris (C. auris) is a multidrug-resistant fungal infection that has emerged as a serious threat in hospitals and long-term care facilities worldwide.
Unlike most fungi, C. auris can survive on human skin and medical surfaces, spread easily in healthcare settings, and resist multiple antifungal medications. Because it typically affects already-ill patients, infections can be severe and sometimes fatal.
Key Points
- Hospital-acquired fungal pathogen
- Resistant to multiple antifungal drug classes
- Spreads via skin contact, surfaces, and equipment
- Primarily affects critically ill or immunocompromised patients
- Prevention and rapid detection are often more effective than treatment alone
Background
C. auris was first identified in 2009 from an ear infection in Japan. Since then, it has spread rapidly across continents and has been reported in many countries.
Public health agencies including the CDC classify Candida auris as an urgent antimicrobial threat because of its resistance patterns, outbreak potential, and the challenges of diagnosis and containment.
Why Candida auris Is Different
Most Candida species can live harmlessly in or on the body. C. auris behaves differently in several critical ways:
- Resistance to multiple antifungal medications
- Ability to survive on hospital surfaces for extended periods
- Easy transmission between patients in healthcare settings
- Frequent misidentification by routine laboratory tests
These features allow outbreaks to occur even in well-resourced hospitals.
Hospital-Acquired Infection Risk Profile
- Primary risk group: ICU patients, long-term care residents, immunocompromised individuals
- Transmission: Skin contact, contaminated equipment, hospital surfaces
- Containment difficulty: Can persist on surfaces and spread silently via colonisation
- Treatment constraints: Limited antifungal drug classes and evolving resistance
Clinical insight: Candida auris is less a community threat and more a healthcare-system stress test, exposing weaknesses in diagnostics, infection control, and antimicrobial preparedness.
Who Is Most at Risk?
- Intensive care unit (ICU) patients
- People on ventilators or feeding tubes
- Patients with central lines or catheters
- Immunocompromised individuals
- Residents of long-term care facilities
Healthy people in the community are not considered at meaningful risk.
Symptoms
Symptoms are often non-specific and may resemble other infections:
- Fever
- Chills
- Low blood pressure
- Signs of bloodstream infection
This overlap can delay appropriate diagnosis and infection control.
Diagnosis
Accurate identification often requires specialized laboratory testing. Standard yeast identification methods may misidentify C. auris, delaying treatment and outbreak containment.
Hospitals may use advanced identification systems and/or public health lab confirmation for suspected cases.
Treatment
Treatment is possible but can be difficult due to resistance:
- Echinocandins are typically first-line therapy
- Susceptibility testing helps guide management
- Combination therapy may be considered in complex cases
Because treatment options are limited, prevention and containment are critical.
Prevention and Infection Control
Hospitals rely on strict infection control measures to prevent spread:
- Hand hygiene (staff and visitors)
- Contact precautions and isolation when indicated
- Dedicated patient equipment when possible
- Enhanced environmental cleaning and disinfection
- Screening of close contacts during outbreaks
Emerging Research
Some research suggests C. auris may rely on specific nutrient-acquisition pathways (including iron scavenging) during infection. If confirmed and translated into therapies, these mechanisms could become future drug targets.
Prognosis
Outcomes depend on:
- The patient’s underlying health and immune status
- Speed of diagnosis and treatment
- Access to effective antifungal therapy
- Quality of infection control and outbreak management
Severe illness and death occur most often in patients who are already critically ill.
FAQ
Q: Is Candida auris contagious?
A: Yes, mainly in healthcare settings through contact with contaminated surfaces or shared medical equipment.
Q: Can healthy people get Candida auris?
A: It’s very unlikely. The highest risk is in hospitalized or immunocompromised patients.
Q: Is Candida auris treatable?
A: Often, but resistance makes treatment challenging. Echinocandins are commonly first-line, guided by testing.
Q: Are there vaccines for Candida auris?
A: No vaccines are currently available, though research is ongoing.