Know the yeast identification method used by your laboratory and its limitations for C. auris identification
Some local public health laboratories offer testing for C. auris identification and confirmation. Contact your local health department for more information.
View the Finding Candida auris in California Clinical Laboratories: Strategies That Work for Us! webinar slides (PDF) and recording (opens in YouTube).
Perform species identification on all yeast from invasive sources
Ensure the laboratory notifies infection prevention immediately following a positive result for C. auris, even if preliminary. Early detection of C. auris is essential for containing its spread in healthcare facilities
Participate in the AR Lab Network Targeted Surveillance Program (PDF) to access confirmatory identification and antifungal susceptibility testing for non-albicans Candida isolates at no cost. Contact HAIProgram@cdph.ca.gov for more information.
Know the local epidemiology and prevalence in your region.
Understand patient risk factors and high risk settings, such as indwelling medical devices in patients residing in high acuity long-term care facilities
When a patient with C. auris is identified, implement screening of high-risk patients and patient contacts for C. auris colonization. Patients colonized with C. auris may not need medical treatment but can be potential sources of transmission to others.
Colonization testing services can be accessed at no cost using the CDC Antibiotic Resistance Laboratory Network (AR Lab Network) for patients admitted to a healthcare facility, including in order of priority*:
High-risk patient contacts of a confirmed C. auris case, such as roommates and other patients residing in the same unit (including for point prevalence surveys (PPS))
Those admitted from facilities with known C. auris transmission
Those who are colonized with carbapenemase-producing organisms; prioritize those with non-KPC carbapenemase and requiring high-level care (e.g., indwelling medical devices, mechanical ventilation)
Those who have recently received healthcare outside the U.S. in the past 12 months, especially where C. auris cases have been reported; prioritize those co-colonized or -infected with carbapenemase-producing organisms
On a case-by-case basis, those who have exposure to multiple healthcare facilities, particularly long-term care facilities with ventilator units, and especially in regions with C. auris transmission
On a case-by-case basis, preemptive PPS in facilities admitting patients from facilities with known C. auris transmission
*Availability of AR Lab Network colonization testing resources based on screening priority. Contact your local health department when considering C. auris colonization testing.
- CDPH does not have any specific recommendations regarding the timing of collecting axilla/groin swabs for C. auris colonization testing relative to chlorhexidine gluconate (CHG) bathing. Healthcare facilities may consider swabbing individuals immediately prior to scheduled CHG or other bathing.
Infection Control Measures
Environmental Cleaning and Disinfection
Ensure and audit thorough daily and terminal environment cleaning of patient care environment and reusable equipment
Focus on high-touch surfaces or any shared reusable patient equipment
CDC recommends use of an EPA registered hospital-grade disinfectant effective against C. auris (List P) Clostridioides difficile spores (List K)
Daily and terminal cleaning and disenfection of patient environment using a List P or List K product may be extended to an entire unit or facility where patients with C. auris are located
Review environmental cleaning checklists that are available on the CDPH HAI Program website
Communicate C. auris status to the receiving facility ahead of time to ensure appropriate care is maintained when transferring a patient/resident
Use the HAI Program interfacility transfer form during all patient transfers available via the Interfacility Transfer Communications Guide page.
Set expectations for facilities to effectively communicate C. auris status when transferring patients/residents to another healthcare facility
During an outbreak, consider requesting facilities notify public health of all discharges and transfers involving individuals with C. auris
- Healthcare providers and laboratories should report C. auris cases (see C. auris Reporting FAQ (PDF))
- Laboratories must report cases through CalREDIE electronic laboratory reporting
- Healthcare providers can use the C. auris case report form through CalREDIE
- Report outbreaks to public health and your local CDPH Licensing and Certification District Office
- Complete relevant investigation information in CalREDIE Lab, Epi Info, and Contacts tabs for C. auris
- Contact HAIProgram@cdph.ca.gov for any suspected and confirmed C. auris:
- cases in Phase 1 or 2 local health jurisdictions (LHJ) (see CDPH C. auris Phases (PDF)); and
- clusters and outbreaks in any LHJ.