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Candida auris. ARUP Consult®. Retrieved August 15, 2025, https://arupconsult.com/content/candida-auris

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Candida auris

Last Literature Review: July 2025 Last Update:

Medical Experts

Contributor

Hanson

Kimberly E. Hanson, MD, MHS
Kimberly E. Hanson, MD, MHS
Professor, Internal Medicine; Adjunct Professor, Pathology, University of Utah School of Medicine
Medical Director, Mycology, ARUP Laboratories
Head, Immunocompromised Host Infectious Diseases Services, University Hospital and Huntsman Cancer Center

Candida auris is a fungus of growing concern due to antifungal drug resistance that can cause potentially life-threatening invasive infections. ,  C. auris is not more virulent than other Candida species, but it can spread rapidly through healthcare facilities via contact with contaminated surfaces and equipment. Patients colonized with C. auris may be asymptomatic but highly contagious, leading to a need for broad inpatient surveillance to support infection control efforts. ,  C. auris requires real-time polymerase chain reaction (PCR) assays or mass spectrometry for accurate identification.  Antifungal susceptibility testing is used to direct treatment. , 

Quick Answers for Clinicians

Why does Candida auris require specialized testing for identification?

Candida auris can be mistaken for similar organisms such as other Candida species when using standard phenotypic yeast identification methods performed on commercially available instruments. ,  Mass spectrometry or sequencing is required to differentiate C. auris from more common species of Candida with a similar appearance, such as C. haemulonii. , 

Should patients who were previously infected or colonized with Candida auris be screened for C. auris?

Patients who were previously infected or colonized with Candida auris should not be rescreened in a healthcare setting.  Patients in healthcare settings can experience C. auris colonization for a prolonged period, and infection control procedures should not be discontinued if a colonized patient is retested for C. auris and receives a negative result. 

Should healthcare workers be screened for Candida auris?

Screening healthcare workers for Candida auris is not recommended, as colonization of healthcare workers is highly unlikely.  Handwashing and standard personal protective equipment are sufficient to prevent C. auris colonization in healthcare workers. 

Laboratory Testing

Screening for Colonization

Healthcare facilities should choose a screening strategy based on the prevalence of C. auris in the facility and surrounding area. Broad screening is generally recommended of all patients or residents in a unit or facility, rather than just those with particular risk factors. ,  Follow-up screening is recommended if ongoing transmission is suspected.  Patients who are at higher risk of becoming colonized with C. auris include :

  • Patients with indwelling medical devices or supported by mechanical ventilation
  • Patients receiving complex or high-acuity medical care
  • Patients who have had frequent or long stays in healthcare facilities at high risk for C. auris
  • Patients who are colonized or infected with other multidrug-resistant organisms

Real-time PCR is the preferred test to screen patients for C. auris colonization due to its high sensitivity, although culture-based testing can be used if real-time PCR is not available. ,  A composite skin swab of a patient’s groin and bilateral axilla is recommended to screen patients for C. auris colonization. 

Diagnosis of Infection

Culture-based tests are recommended for diagnosis of infection, as organism isolates are needed for subsequent susceptibility testing and public health surveillance. Mass spectrometry or sequencing is necessary for accurate identification of C. auris in culture because standard phenotypic yeast identification methods can misidentify C. auris. , 

Antifungal Susceptibility Testing

Antifungal susceptibility testing should be performed on all C. auris isolates to guide therapy.  Susceptibility breakpoints are based on similar Candida species and expert opinion, as there are no established breakpoints for C. auris. 

ARUP Laboratory Tests

References