Health Information Portal (HIP)

Candida Auris

Topic	Priority Priority Alert Conveys the highest level of importance; warrants immediate action or attention. Advisory Provides important information for a specific incident or situation; may not require immediate action. Notification Provides information regarding an incident or situation; unlikely to require immediate action. Update Provides updated information regarding an incident or situation; unlikely to require immediate action.	Date of Alert
Update: Outbreak and Containment of Candida auris in PA Healthcare Facilities	Advisory	Mar 31, 2023
Update: Outbreak and Containment of Candida auris in PA Healthcare Facilities	Update	Aug 8, 2022
Update: Outbreak and Containment of Candida auris in PA Healthcare Facilities	Advisory	Aug 3, 2021
New Outbreak and Containment of Candida Auris in PA Healthcare Facilities	Alert	May 28, 2021

Surveillance

• Candida auris Case Definition: A positive culture of Candida auris or Candida haemulonii (Candida auris is frequently misidentified as Candida haemulonii) from any body site including, but not limited to, blood, wound, skin, ear, urine, rectum, and respiratory tract, collected for diagnostic purposes or surveillance/screening purposes.
• National Candida auris Surveillance Data
• PDPH Candida auris Surveillance Data

Vaccine Information

• There is currently no vaccine to prevent Candida auris.

Diagnosis & Management

• Candida auris infection is diagnosed through a culture of the affected body site. Candida auris can be frequently misidentified when using traditional phenotypic methods for yeast identification such as VITEK 2 YST, API 20C, BD Phoenix yeast identification system, and MicroScan. Common misidentifications are listed here. If any of these species are identified, or if species identity cannot be determined, further characterization using appropriate methodology should be sought. Please email the HAI/AR team at HAI.PDPH@Phila.gov or call at (215) 685-4501 for assistance with this.
• Candida auris is often resistant to many antifungal drugs, although some infections can be treated with antifungal medicines. Providers should order antifungal susceptibility testing to determine the appropriate drug for treatment.
• Candida auris colonization is primarily identified through a culture or a PCR based test from a swab collected from the axilla and/or groin. CDC does not recommend treatment of Candida auris identified from noninvasive body sites (such as respiratory tract, urine, and skin colonization) when there is no evidence of infection.
• Report all cases (colonization or infection) to PDPH immediately and retain Candida auris isolates for one month following identification. PDPH will follow up to coordinate further testing.
• CDC Laboratory Protocol for Detecting Candida auris
• CDC Antifungal Susceptibility Testing & Interpretation
• CDC Screening for Candida auris Colonization
• CDC Treatment and Management of Infections and Colonization with Candida auris
• CDC Lab Safety Considerations When Working with Candida auris
• CDC Testing Algorithm

Reporting to PDPH

• Report all C.auris cases (colonization or infection) to the Philadelphia Department of Public Health by calling 215-685-6748 within 24 hours. Complete the Candida auris Report Form and fax to 215-238-6947 after reporting the case by phone.
  • PDPH Candida auris Report Form

Guidelines for Management and Control:

• CDC Guidelines: Infection Prevention and Control for Candida auris

Hospitalized Patients:

• Candida auris patients shall be placed on contact precautions and in a private room for the duration of all current and future healthcare stays.
• Because patients may remain colonized for more than one year, do not discontinue precautions when the infection clears. There is not enough evidence to make a firm recommendation about when to discontinue use of Contact Precautions for infected or colonized patients.

Long-Term Care Facility Residents:

• PDPH Guidance for Inter-facility transfer
  • Prior to patient transfer, the transferring facility should notify the receiving facility of the Candida auris colonization or infection.
• PDPH C. auris Information for Families and Residents

Disinfection Guidance:

• Candida auris can persist on surfaces in healthcare environments. Meticulous cleaning and disinfection of both patient rooms and mobile equipment is necessary to reduce the risk of transmission.
• Until further information is available for Candida auris, CDC recommends use of an Environmental Protection Agency (EPA)-registered hospital-grade (LIST K) disinfectant effective against Clostridioides difficile spores. It is important to follow all manufacturers’ directions for use of the surface disinfectant, including applying the product for the correct contact time.
• Solution with 10% bleach should be made fresh daily.
• Reusable equipment should be dedicated to the colonized or infected patient whenever possible.
• Shared reusable medical equipment should be disinfected immediately after use. 
• Daily disinfection, with products appropriate for Candida auris, that includes areas in close proximity to the patient, high-touch surfaces in the room, as well as surfaces around sinks and toilets.
• Immediate cleaning and disinfection of equipment or surfaces contaminated with blood, serum, urine, purulent discharges, feces, and other bodily fluids or infectious materials.
• Terminal cleaning shall consist of thorough wet cleaning and disinfection. Specific products should be utilized based on the identified organism. 
• Additional Resources: NY State Hospital Association Candida auris Cleaning Video and EPA Registered Disinfectant Products for Candida auris

Resources

For Healthcare Providers:

• PADOH/PDPH C. auris Infographic
• PADOH Healthcare Facility Toolkit for Response to Candida auris
• CDC About Candida auris (C. auris)
• PDPH Candida auris Toolkit
• CDC Candida auris Fact Sheets (Under Disease-specific graphics)
• Healthcare Happenings: IPC Highlights Newsletter on Candida auris

PA C. auris Symposium Presentations

• PDPH LTCF Collaborative Call (June 2021) - Candida auris presentation
• PDPH Webinar (September 2020) - The Changing Epidemiology of Fungal Pathogens (includes information on Candida auris)
• PDPH Collaborative Meeting (February 2018) PowerPoint – Candida auris: Epidemiology, surveillance, and prevention

For Patients and Community Members:

Posters:

There are no posters for Candida Auris.