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Candidozyma auris

What is it?

Candidozyma auris (formerly Candida auris) is an opportunistic fungal pathogen that can cause serious infections in people who are immunocompromised.1,2 Candidozyma auris (C.auris) is often resistant to antifungal medications, making infections difficult, or in some cases, impossible to treat.3  

First described in Japan in 2009, C.auris has emerged as a significant healthcare-associated pathogen with multidrug resistance, environmental persistence and a capacity for rapid transmission, contributing to its global spread.4 Surveillance data has indicated cases continue to expand globally, with the United States reporting 4,514 cases in 2023, bringing the total to over 20,000 cases, and over 4,000 cases in Europe up to 2023.4 Cases of C.auris in Australia and New Zealand have remained relatively low. In Australia, isolates have been increasing over the past 5 years, with 16 reports of C.auris in 2024, and 17 from January to September 2025,5 with the most common risk factor for C.auris being recent overseas hospitalisation for a prolonged period.6 

Symptoms

In most cases, people are colonised with C.auris and display no symptoms.1 In unwell or immunocompromised people, symptoms depend on the location and severity of infection, ranging from superficial skin infections to severe bloodstream infections.3 There is no common set of specific symptoms for C.auris infections.3 

The mortality rate of candidemia by C.auris, has been reported to be around 30%, and is dependent on the patient’s demographics and underlying conditions at the time.4 

How is it transmitted?

Transmission occurs primarily through contact, either directly between patients and healthcare workers or indirectly through contaminated surfaces and devices.4  C.auris can contaminate gowns, gloves and hands of staff, and lapses in the use of personal protective equipment (PPE) and hand hygiene can contribute to the spread.4  

Shared medical equipment, including blood pressure cuffs and ultrasound probes have been repeatedly implicated in the transmission of C.auris.4 

C.auris has been found to efficiently colonise the skin and mucosa, which can enhance its transmissibility, and a high microbial burden on the skin can contribute to environmental contamination through skin shedding.4 

C.auris has demonstrated significant environmental resilience and persistence, and in healthcare settings has been found to form biofilms on the surface it contaminates, surviving for prolonged periods on both dry and moist surfaces, from weeks to months.2,4 It has also demonstrated tolerance to many commonly used disinfectants, including quaternary ammonium compounds, which have poor activity against C. auris,2 which means that standard cleaning programs may not eradicate the organism, leading to ongoing contamination and prolonged outbreaks.4 Studies have demonstrated that sodium hypochlorite and hydrogen peroxide vapour are more effective disinfection methods.2,4 

The combination of persistence within the environment, high colonisation and spread within the healthcare setting creates a cycle of contamination and transmission, whereby colonised patients contaminate their surroundings, new patients become colonised, and further contamination continues.4 

At risk groups?

Populations at risk of C.auris infection include people with prolonged intensive care (ICU) stays, invasive medical procedures and devices and recent or prolonged use of antimicrobial agents.3,4 People who are colonised with C.auris may remain colonised for long periods of time and when exposed to risk factors for candidemia, 20-25% of colonised people will progress to infection.4 

Prevention?

Transmission can be prevented through strong Infection prevention and control measures. Strategies include early screening and notification, patient placement in single rooms, contact precautions for the duration of hospitalisation, hand hygiene with alcohol-based hand rub, and cleaning with disinfectants effective against C.auris.4 

Active screening programs to identify colonised people are a key strategy that can prevent spread within clinical areas.4  

Key messages:

  • Candidozyma auris is a highly transmissible fungal pathogen with significant implications for healthcare settings. 
  • It persists in the environment for long periods of time. 
  • Early detection and screening are critical to preventing transmission in healthcare settings.  

References

  1. Better Health Channel. Candida auris (C.auris). Victorian Department of Health. Accessed 18 March, 2025.https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Candida-auris
  2. Cristina ML, Spagnolo AM, Sartini M, et al. An Overview on Candida auris in Healthcare Settings.Journal of Fungi. 2023;9(9):913. doi:10.3390/jof9090913 
  3. Centers for Disease Control and Prevention. About C.auris. U.S. Department of Health And Human Services. Updated Feb 26 2026. Accessed 18 March, 2026.https://www.cdc.gov/candida-auris/about/index.html
  4. Salmanton-García J, Nóbrega de Almeida J, Colombo AL. Candidozyma auris (formerly Candida auris): resistant, long lasting, and everywhere.Clinical Microbiologyand Infection. 2026/03/01/ 2026;32(3):374-381. doi:https://doi.org/10.1016/j.cmi.2025.12.022 
  5. Australian Commission on Safety and Quality in Health Care.CARAlert data update 42: 1 July to 30 September 2025. 2025.https://www.safetyandquality.gov.au/sites/default/files/2025-12/caralert_data_update_42.pdf 
  6. Australian Commission on Safety and Quality in Health Care. Candida auris. Australian Commission on Safety and Quality in Health Care,. Accessed 18 March, 2026.https://www.safetyandquality.gov.au/our-work/infection-prevention-and-control/candida-auris