Hygiene measures in case of Candidozyma auris (formerly Candida auris)

Since its first description in Japan in 2009, a continuous increase in the number of Candidozyma auris cases has been observed worldwide [1,2]. The often multidrug-resistant yeast Candidozyma auris challenges hygiene experts around the world. The pathogen can trigger infections that are hard to treat; ill and immunosuppressed patients are at particular risk. The US federal agency CDC (Centers for Disease Control and Prevention) explicitly warns against this yeast, since it is resistant to many common antifungal drugs (e.g. fluconazole) and is difficult to detect by standard laboratory methods [3]. Among other things, this was a reason for the WHO to classify C. auris in the ‘critical group’ of fungal pathogens in 2022 [4].

In 2024, Candida auris and related species were assigned to the new genus Candidozyma based on detailed phylogenomic and comparative genomic analyses [5].

Existing data suggests that in hospitals C. auris may spread in patterns that are similar to those of methicillin-resistant Staphylococcus aureus (MRSA). For prevention of transmission and outbreak it is therefore important to correctly identify C. auris and to apply targeted hygiene measures [6,7].

Symptoms and clinical picture

C. auris may elicit ear, surgical site and urinary tract infections. If the yeast enters the bloodstream, also fatal bloodstream infections can occur.

Transmission route: contact infection

Transmission of C. auris occurs through direct contact with contaminated persons or through indirect contact with contaminated objects. Medical devices, objects, and surfaces in the direct patient environment play special role [4]. C. auris is a particularly environmentally stable yeast: on inanimate surfaces, the pathogen can survive for up to three weeks [8].

Infection control measures in case of C. auris [9-11]

• Contact isolation
  Patients with C. auris should be isolated to contain a spread of the yeast. If possible, the number of employees having contact to the isolated patient should be reduced to a minimum.
  
  
• Hand hygiene in case of C. auris
  When taking care of patients with C. auris, particular attention should be paid to the hygienic hand disinfection. The 5 Moments for Hand Hygiene apply here.
  When treating isolated patients, employees should additionally use gloves and avoid touching surfaces outside the patient surroundings with the gloved hands. Please note: gloves do not replace hand disinfection. The hands must therefore undergo hygienic hand disinfection before donning and after having removed the gloves.

• Surface disinfection
  C. auris is very stable in the environment and can survive on surfaces for several days. In general, for inactivation of yeasts a yeasticidal disinfectant is recommended, which was tested e.g., according to EN13624 and EN16615 against Candida albicans. Due to the high environmental stability of C. auris, HARTMANN has tested the two surface disinfectants Mikrobac® forte and Dismozon® plus against C. auris. Both are effective against C. auris when applied in exposure times and concentrations as for the standard yeasticidal activity. In cases of C. auris, a yeasticidal disinfectant can therefore be used.

Do you have questions regarding C. auris and the choice of the adequate disinfectant? We will gladly help you!

Click here to view products with yeasticidal spectrum of activity.

Sources:

1. Satoh K et al. (2009) Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol Immunol. 53(1):41-4. https://doi.org/10.1111/j.1348-0421.2008.00083.x
2. Plachouras D et al. (2020) Candida auris survey collaborative g. Candida auris: epidemiological situation, laboratory capacity and preparedness in the European Union and European Economic Area*, January 2018 to May 2019. Euro Surveill. 2020;25(12).
3. CDC Centers for Disease Control and Prevention: Candida auris. https://www.cdc.gov/candida-auris/index.html (zuletzt geprüft am 22.04.2025).
4. World Health Organization (2022) WHO fungal priority pathogens list to guide research, development and public health action https://www.who.int/publications/i/item/9789240060241 (accessed on 22.04.2025)
5. Liu et al. (2024) Phylogenomic analysis of the Candida auris-Candida haemuli clade and related taxa in the Metschnikowiaceae, and proposal of thirteen new genera, fifty-five new combinations and nine new species. Persoonia 52:22-43.
6. Epidemiologisches Bulletin Nr. 18. Robert Koch-Institute, May 2024.
7. Nationales Referenzzentrum für invasive Pilzinfektionen (2019) Kurzinfo: Candida auris, doi: 10.4126/FRL01-006416490.
8. Wißmann JE et al. (2021) Persistence of Pathogens on Inanimate Surfaces: A Narrative Review. Microorganisms. 9:343.https://doi.org/10.3390/microorganisms9020343
9. Assadian O et al. (2021) Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review. J Hosp Infect 113:104-114.
10. Centers for Disease Control and Prevention – Infection Control Guidance: Candida auris https://www.cdc.gov/candida-auris/hcp/infection-control/(accessed on 22.04.2025).
11. European Centre for Disease Prevention and Control (2018) Candida auris in healthcare settings – Europe – first update, 23 April 2018. Stockholm: ECDC, https://www.ecdc.europa.eu/sites/default/files/documents/RRA-Candida-auris-European-Union-countries.pdf (accessed on 22.04.2025).

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