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Candida auris Hospital Infection

Emerging multidrug-resistant fungal pathogen with high mortality and outbreak potential.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Candida auris Hospital Infection?

Candida auris is an emerging multidrug-resistant yeast first identified in 2009 in Japan and now reported globally as a serious healthcare threat. It causes invasive infections including candidemia, wound infections, and otic infections, particularly in critically ill patients with multiple comorbidities and prolonged hospital stays. Mortality of invasive infection ranges 30-60%.

Key concerns are misidentification by routine biochemical methods (often as Candida haemulonii or Candida famata), persistence on hospital surfaces and skin for weeks, resistance to multiple antifungal classes (most isolates resistant to fluconazole, many to amphotericin B, some pan-resistant), and rapid clonal spread between patients. MALDI-TOF MS or molecular methods are required for accurate identification.

Containment requires single-room isolation, contact precautions, dedicated equipment, terminal cleaning with chlorine-based disinfectants (quaternary ammonium ineffective), screening of contacts, and notification of public health authorities. Treatment is guided by susceptibility testing; echinocandins are first-line, with amphotericin B for resistant cases. Clinical microbiology, infection prevention, and stewardship coordination are essential.

Symptoms

Persistent fever despite broad-spectrum antibiotics in ICU
Hemodynamic instability of unclear etiology
Bloodstream infection (candidemia)
Wound infection unresponsive to antibacterial therapy
Otitis (ear discharge, pain)
Catheter-related infection
Urinary tract infection in catheterized patients
Disseminated candidiasis with end-organ involvement
Skin and soft tissue infection
Asymptomatic colonization detected on screening
Outbreak cluster signaling on infection surveillance

Risk Factors

Prolonged ICU stay
Indwelling devices (central lines, urinary catheter, mechanical ventilation)
Prior broad-spectrum antibiotic exposure
Recent surgery, especially abdominal
Diabetes mellitus
Chronic kidney disease and dialysis
Immunosuppression and transplantation
Malignancy with chemotherapy
Total parenteral nutrition
Hospital outbreak setting
Travel to endemic regions or referral from affected facilities

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent unexplained fever in ICU patient
  • Septic shock without bacterial source
  • Wound or otic infection failing antibacterial therapy
  • Recent hospitalization in outbreak facility
  • Positive yeast identification needing confirmation
  • Cluster of cases in unit
  • Contact of confirmed C. auris case

Treatment Methods

01
Send blood, wound, or other specimens for fungal culture and species identification by MALDI-TOF MS
02
Antifungal susceptibility testing for all isolates (fluconazole, voriconazole, echinocandins, amphotericin B)
03
Empiric echinocandin (caspofungin, micafungin, anidulafungin) while awaiting susceptibility
04
De-escalate or escalate based on susceptibility results
05
Liposomal amphotericin B for echinocandin-resistant or refractory disease
06
Combination therapy considered for pan-resistant strains
07
Remove or replace infected devices (central lines, catheters)
08
Source control: drainage of abscesses, debridement of wounds
09
Single room isolation with contact precautions for confirmed and suspected cases
10
Dedicated equipment (stethoscopes, BP cuffs); discard or sterilize between use
11
Strict hand hygiene with alcohol-based hand rub (chlorhexidine wipes for skin decolonization)
12
Environmental cleaning with EPA List P disinfectant (chlorine 1000 ppm or hydrogen peroxide)
13
Screening of high-risk contacts (axilla, groin swabs)
14
Notify infection prevention, public health authority, regional reference lab
15
Cohort positive patients and dedicated staff during outbreaks
16
Discontinue colonization screening only after negative cultures and per local protocol
17
Antifungal stewardship: avoid empiric fluconazole in colonized patients
18
Monitor for relapse after treatment with weekly blood cultures
19
Patient and family education on hand hygiene and isolation
20
Long-term follow-up imaging for endocarditis or end-organ disease

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.