C. auris for Healthcare Providers

Healthcare facilities should review CDC's Infection Prevention and Control for Candida auris. Key recommendations for suspected or confirmed C. auris infection or colonization are included below.

Laboratory Identification and Reporting

  • Laboratories should notify the facility infection preventionist(s) of any suspicious isolates.
  • According to the New York City and New York State laboratory communicable disease reporting guidelines, laboratories should submit all clinical and surveillance isolates that are suspected or confirmed to be C. auris. Currently, all C. auris positive isolates should be submitted to NYSDOH Wadsworth Center. Additionally, laboratories performing polymerase chain reactions for C. auris without culture abilities, should submit all positive surveillance samples.
  • C. auris is considered an emerging multidrug-resistant pathogen, and cases of C. auris infection or colonization that occur in hospitals, nursing homes, and other healthcare facilities licensed under Article 28 of the NYS Public Health Law must be reported to the NYSDOH Regional Epidemiologist or the NYSDOH Bureau of Healthcare Associated Infections Central Office.
    • NYSDOH Regional and Central Office Contact Information:
      • Western Regional Office (585) 423-8907
      • Central New York Regional Office (315) 477-8165
      • Metropolitan Area Regional Office (914) 654-7149
      • Capital District Regional Office (518) 474-1142
      • Central Office (518) 474-1142
  • Reporting requirements and instructions for NYSDOH facilities licensed under Article 28 of the Public Health Law are available at: Reporting Requirements
  • Suspected or confirmed C. auris isolates that are identified in other healthcare settings can be reported to the local health department where the patient resides: County Health Departments

Infection Prevention and Control

  • If C. auris infection or colonization is suspected, healthcare facilities should consult with their NYSDOH Regional Epidemiologist and follow all applicable infection prevention and control recommendations found on CDC's Infection Prevention and Control for Candida auris webpage.

Environmental Cleaning and Disinfection

  • Facilities and practices should verify that they are using an EPA-registered hospital grade disinfectant from EPA List P with claims against Candida auris for disinfection related to C. auris.
  • All healthcare settings should ensure that appropriate and effective daily and terminal cleaning and disinfection is performed in rooms, units, and procedure/treatment areas where patients or residents with C. auris are located or have been present.
  • Ensure appropriate and effective cleaning and disinfection of reusable equipment, particularly shared mobile equipment, follows manufacturer's instructions and uses recommended products with effectiveness against C. auris.
  • Infection preventionists are strongly encouraged to directly monitor compliance with hand hygiene, use and disposal of personal protective equipment, and environmental cleaning and disinfection.

Interfacility Transfers

  • Before patients or residents known to have C. auris are transferred to another healthcare facility, the transferring facility should notify the receiving facility by telephone of the patient's C. auris infection or colonization so the receiving facility can implement the appropriate level of precautions required.
  • C. auris diagnosis and infection prevention and control measures should be featured prominently in the patient's or resident's discharge or transfer documentation to facilitate infection prevention and control practices throughout the healthcare continuum.

Surveillance cultures

  • When a patient or resident with C. auris infection or colonization is identified in a facility, consult with NYSDOH Regional Epidemiologists on strategies to perform colonization screening of close healthcare contacts. See CDC's Screening for Candida auris Colonization for details.
  • At the direction of NYSDOH Regional Epidemiologists, NYSDOH Wadsworth Center can provide supplies and shipping to process primary samples for colonization screening from patients.

Frequently Asked Questions (FAQs):

When should laboratories and healthcare providers suspect C. auris?

C. auris can be misidentified as a number of different organisms when using traditional biochemical methods for yeast identification. Information on laboratory diagnosis including how C. auris can be misidentified and when C. auris should be suspected is available on the CDC's Identification of Candida auris webpage.

How can the spread of C. auris be prevented?

  • Meticulous attention to infection prevention and control, including good hand hygiene (either hand sanitizing with an alcohol-based hand sanitizer or hand washing with soap and water), proper selection, use, and disposal of personal protective equipment, and appropriate and effective environmental cleaning and disinfection are keys to prevention.
  • Healthcare facilities should review all recommendations from the NYSDOH and the CDC regarding C. auris infection prevention and control and should monitor the NYSDOH and CDC websites for new information and revisions to current recommendations.
  • Key CDC recommendations are summarized below along with additional NYSDOH recommendations.

When should antifungal susceptibility testing for C. auris be performed and how should results be interpreted?

  • All C. auris isolates should undergo antifungal susceptibility testing.
  • Because no C. auris-specific susceptibility breakpoints have been established, breakpoints have been defined based on those established for closely related Candida species and also based on expert opinion, and are presented in the CDC's "Candida auris Antifungal Susceptibility Testing and Interpretation"

What are the suggested treatment regimens for invasive C. auris infections (e.g., bloodstream infections, intra-abdominal infections) in adults?

Treatment considerations are available within the CDC's Treatment and Management of C. auris Infections and Colonizations

Health Advisories

Supplemental Materials

Select NYSDOH publications

  • CDC Morbidity and Mortality Weekly Report (MMWR): Nov. 11, 2016 "Investigation of the First Seven Reported Cases of Candida auris, a Globally Emerging Invasive, Multidrug-Resistant Fungus-United States, May 2013-August 2016": www.cdc.gov/mmwr/volumes/65/wr/mm6544e1.htm
  • Rowlands J, Dufort L, Chaturvedi S, et al. Candida auris admission screening pilot in select units of New York City health care facilities, 2017-2019. Article in press. Published online January 31, 2023. DOI: https://doi.org/10.1016/j.ajic.2023.01.012
  • Ostrowsky B, Greenko J, Adams E, et al. Candida auris isolates resistant to three classes of antifungal medications–New York, 2019. MMWR Morb Mortal Wkly Rep. 2020; 69: 6-9
  • Zhu Y, O'Brien B, Leach L, et al. Laboratory analysis of an outbreak of Candida auris in New York from 2016 to 2018: impact and lessons learned. J Clin Microbiol. 2020; 58: e01503-e01519. DOI: https://doi.org/10.1128/JCM.01503-19
  • Adams E, Quinn M, Tsay S, et al. Candida auris in healthcare facilities, New York, USA, 2013–2017. Emerg Infect Dis. 2018; 24: 1816-1824 DOI:: 10.3201/eid2410.180649
  • Rossow J, Ostrowsky B, Adams E, et al. Factors associated with Candida auris colonization and transmission in skilled nursing facilities with ventilator units, New York, 2016-2018. Clin Infect Dis. 2021; 72: E753-EE60. DOI: 10.1093/cid/ciaa1462
  • Leach L, Zhu Y, Chaturvedi S. Development and validation of a real-time PCR assay for rapid detection of Candida auris from surveillance samples. J Clin Microbiol. 2018; 56 (e01223-17)
  • Southwick K, Ostrowsky B, Greenko J, et al. A description of the first Candida auris-colonized individuals in New York State, 2016-2017. Am J Infect Control. 2022; 50: 358-360
  • Leach L, Russell A, Zhu Y, Chaturvedi S, Chaturvedi V. A rapid and automated sample-to-result Candida auris real-time pcr assay for high-throughput testing of surveillance samples with the bd max open system. J Clin Microbiol. 2019; 57 (e00630-19)
  • Zhu Y, Hager KM, Manjari SR, Banavali NK, Chaturvedi V, Chaturvedi S. Development and Validation of TaqMan Chemistry Probe-Based Rapid Assay for the Detection of Echinocandin-Resistance in Candida auris. J Clin Microbiol. 2023 Apr 20;61(4):e0176722. doi: 10.1128/jcm.01767-22. Epub 2023 Mar 28. PMID: 36975998; PMCID: PMC10117040.