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Antimicrobial Resistant Organisms

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About Candida auris (C. auris)

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Candida auris (C. auris) is an emerging multi-drug resistant fungus that has caused increasing numbers of outbreaks and invasive infections that are associated with high mortality (>40%) in health care facilities across multiple countries.1–3 C. auris can be resistant to one or three main available classes of antifungal treatments (e.g., azoles such as fluconazole, polyenes such as amphotericin B, and echinocandins). Additionally, the organism can survive for long-periods of time on environmental surfaces and fomites, and can be resistant to some common hospital-grade disinfectants, such as quaternary ammonium compounds4C. auris can live on the skin and mucous membranes of people who are colonized with it, and yet they can remain asymptomatic. Patients are at risk of acquiring C. auris if they have been hospitalized in other countries or have been in a health care facility experiencing transmission events/outbreaks. Infections with significant morbidity and mortality are more likely to occur in patients with pre-disposing risk factors such as having central venous catheters or other invasive lines/devices, receiving intensive care, treatment with broad-spectrum antibiotics or antifungals, and being immune compromised.1,2


C. auris has the potential for transmission within health care facilities, including acute and long-term care facilities by causing healthcare-associated infections, including invasive infections with significant morbidity and mortality. The infections can be difficult to diagnose, and when diagnosed can be difficult to treat due to the limited treatment options. Both the patient and the patient’s environment can be colonized with C. auris, which can persist in the environment. Although cleaning and disinfection can remove C. auris, care must be taken to select disinfectants that are effective against the organism. Transmission from patients or the environment can potentially cause outbreaks that can be disruptive and challenging to manage. Therefore, awareness of C. auris and the recommended measures to recognize and prevent transmission are needed to address this emerging concern within health-care settings.


Early identification, adherence to routine infection prevention and control (IPC) practices, and implementation of additional measures are critical to prevent transmission of C. auris within health-care facilities. In addition to IPC control policy and procedures, the following are recommended for patient’s suspected or confirmed to have C. auris:1,5

    • Consult with medical microbiologist for specimen collection and testing.
    • Follow routine practices, including hand hygiene with alcohol-based hand rub or plain soap and water.
    • Implement contact precautions including wearing gloves and long-sleeve protective gowns. Use additional PPE based on point-of-care risk assessment.
    • Place patient in a single occupancy room with a dedicated washroom.
    • Use disposable or dedicate patient care equipment and supplies to the patient as much as possible. If shared patient care equipment is used, it must be cleaned and disinfected after patient use.
    • Use a disinfectant with a Health Canada issued drug identification number (DIN) and an efficacy claim against C. auris (e.g., accelerated hydrogen peroxide, 1,000 ppm chlorine or sodium hypochlorite), for environmental and non-critical equipment cleaning and disinfection.
    • Perform twice daily environmental cleaning and disinfection with a focus on high-touch surfaces.
    • Notify institutional IPC team and Public Health. C. auris is a reportable communicable disease under the Public Health Act.6
    • Consult with institutional IPC teams (where available) or Public Health for further recommendations on the follow-up and management of patient contacts in health-care facilities.
    • Follow additional measures recommended by IPC and/or Public Health, which may include contact tracing, point prevalence testing, environmental sampling, IPC compliance monitoring, and enhanced unit cleaning and disinfection.


  1. Chen J, Tian S, Han X, et al. Is the superbug fungus really so scary? A systematic review and meta-analysis of global epidemiology and mortality of Candida auris. BMC Infect Dis. 2020;20(1):1-10. doi:10.1186/S12879-020-05543-0/TABLES/1
  2. Cadnum JL, Shaikh AA, Piedrahita CT, et al. Effectiveness of Disinfectants Against Candida auris and Other Candida Species. Infect Control Hosp Epidemiol. 2017;38(10):1240-1243. doi:10.1017/ICE.2017.162
  3. Infection Prevention and Control for Candida auris | Candida auris | Fungal Diseases | CDC. Accessed April 11, 2023.
  4. Government of British Columbia. Reporting Information Affecting Public Health Regulation.; 2019. Accessed April 13, 2023.
  5. Public Health Agency of Canada (PHAC). Notice: Candida auris interim recommendations for infection prevention and control. Published 2022. Accessed April 11, 2023.
  6. U.S. Centers for Disease Control and Prevention (CDC). Candida auris. Published 2022. Accessed April 11, 2023.

BC Guidelines, Toolkits and Publications

Carbapenemase Producing Organisms (CPO) Toolkit
Created by: PICNet
September 2014, updated 2015

Notice: The Carbapenemase Producing Organisms (CPO) Toolkit is currently being reviewed and updated. We will notify our community of practice and partners once the resource is revised and approved for publication.

Antibiotic Resistant Organism (ARO) Guidelines (2013)
Created By: PICNet
March 2013

Vanomycin Resistant Enterococci (VRE) Discussion Paper (2014)
Created By: PICNet
March 2013