Candida auris - including symptoms, treatment and prevention

Candida auris (C. auris) is a multi-drug resistant fungus (yeast) that can cause serious infections. Infections caused by C. auris are difficult to treat and are associated with increased mortality and high health care costs.

Candida auris is a notifiable condition1

How C. auris is spread

C. auris can spread through person-to-person contact with a person carrying the fungus with no symptoms (colonisation) or an infected person by direct contact or uncleaned surfaces and patient-shared equipment. C.auris can also remainpersistantin an uncleaned environment, allowing for transmission between patients.

Identifying C.auris is critical to knowing what steps to take to manage it in a healthcare setting, residential aged care facilities and long term care facilities, including implementation of appropriate infection prevention and control measures.

Signs and symptoms

In many cases, a person may carry C. auris in their body or on medical devices in their body (such as feeding tubes, intravenous catheters, urinary catheters and central lines) and not have any symptoms (this is called colonisation).

People can also become very sick from C. auris infection, which can include bloodstream infections, as well as specific infections of various body parts, such as bones (osteomyelitis), ear (otitis media), brain lining (meningitis), heart lining (pericarditis), urinary tract infections or wound infections. The signs and symptoms a person who has a C. auris infection might experience depends on the site of the infection.

Diagnosis

Diagnosis is made by taking a blood sample or a swab of an infected site, which then grows C.auris in the laboratory.

C. auris can be difficult to identify in the laboratory, so the diagnosis may be suspected when a person has a fungal infection that does not respond to the usual treatment.

Incubation period

(time between becoming infected and developing symptoms)

  • Unknown.

Infectious period

(time during which an infected person can infect others)

  • Unknown; people who carry (are colonised) or infected with C. auris are considered to be infectious indefinitely.

Treatment

C. auris is resistant to many of the common antifungal medications. Treatment is guided by an Infectious Diseases physician.

Prevention

Infections with C. auris can be prevented by the following measures:

  • Screening of people who are considered to be at risk of being colonised by C. auris when they are admitted to hospital. Screening involves taking a swab of the underarm (axilla) and groin areas to identify whether the person has been colonised.
  • People who have been to certain countries (such as the UK, India, Pakistan, China, South Africa and parts of the USA) and have been admitted to healthcare services or residential care in these areas are at increased risk. The risk is also increased if such people have had a prolonged hospital stay, have an impaired immune system or diabetes mellitus, have an indwelling medical device, or have had recent surgery.
  • Patients who have C. auris are managed in hospital in a single room and should have a dedicated bathroom. Staff will wear personal protective equipment (PPE) when entering the patient room. The patient’s room, bathroom and dedicated equipment should be cleaned daily (as a minimum) with a chlorine based solution.
  • People who have been colonised/infected with C. auris should tell healthcare facilities and providers so that appropriate infection prevention and control measures can be taken.
  • People who have been colonised/infected with C. auris and their friends/family should practice good hand-washing with soap and water, or alcohol hand gel.
  • Infection prevention and control staff provide advice and support to patients, carers and healthcare services managing people with C. auris.

  • Tissues used by patients should be disposed of carefully.

1 – In South Australia the law requires doctors and laboratories to report some infections or diseases to SA Health. These infections or diseases are commonly referred to as 'notifiable conditions'.