Candida auris

What is Candida auris?

Candida is a group of fungi (yeasts) that live on the skin and inside the human body. Candida auris, or C.auris, is uncommon in Australia, but it can cause serious infections, such as bloodstream and wound infections, that are difficult to treat. C. auris was first reported in 2009, and has spread quickly to many countries across the world. Currently, C. auris is still very rare in Australia.

Why is Candida auris a problem?

C.auris is a problem because it:

• can cause serious infections
• is difficult to treat as some of the medications usually used are no longer effective
• is hard to identify in the laboratory
• spreads easily between patients in hospitals and nursing homes.

Who can get Candida auris?

In Australia, most cases of C.auris have been found in patients who have been exposed to the fungus in an overseas hospital. These people can carry the fungus on their body without it causing any symptoms or an infection. This is called colonisation. In people who are very sick, such as those in intensive care units or those with a weak immune system, it may cause serious infections. These people are said to be infected.

How is Candida auris spread?

C.auris can spread person-to person through contact with someone who is colonised or infected and also via shared equipment that has not been adequately cleaned or disinfected. C.auris can survive on surfaces for long periods, so inadequate cleaning of the environment is another way it can spread. C. auris cannot be caught through coughing or sneezing or through breathing it in the air.

Can Candida auris infection be treated?

Yes. C.auris infections can be treated with antifungal drugs, however, some C.auris have become resistant (this means some medications are no longer effective), to the three main types of antifungal drugs, making them more difficult to treat. Your doctor may have to use multiple antifungal drugs at high doses to treat severe infections. Your doctor will talk to you about the treatment you may require.

Who is screened for Candida auris?

All patients on admission to hospital will be asked if you have been in a hospital outside of Australia in the past year. If you answer ‘Yes’, then the nurse or doctor will organise to collect some samples from you for testing. This just involves wiping a cotton swab over the skin in your armpits and your groin, which are body sites where C.auris is often found.

What will happen if I have Candida auris?

If you are colonised or infected with C. auris, you will still receive the same level of care in hospital, however, some extra precautions will be required which include:

• being moved to a single room with your own bathroom 
• everyone, including staff, visitors and you, will need to wash their hands or use an alcohol-based hand rub before entering and leaving your room
• all staff will wear gowns and gloves when coming into your room
• an alert will be placed in your medical record to let your treating healthcare team know you have C. auris. This alert can be seen in all public hospitals in Western Australia (WA). Should you go to a private hospital, or another healthcare provider, e.g. your local doctor or physiotherapist, you need to tell them you have C.auris. There is no need to tell other community services or businesses that are not health care services e.g. swimming pools, gyms or schools that you have C. auris.
• you can still have visitors, but your visitors must not use your hospital bathroom or visit any other patients in hospital immediately after visiting you 
• it is not known how long people can remain colonised with C.auris, but it is likely to be many months. Repeated hospital admissions and treatment with antifungal drugs will increase the risk of ongoing colonisation.

What will happen when I go home?

There is no need to take special precautions at home, but it is important that you and your family continue to practice good hygiene including:

• always washing your hands with soap and water
  
  • after going to the toilet
  • before preparing or eating food
  • before and after touching any wounds or medical devices that you may have
• using your own towels and face cloths. Do not share these items with other people.

No special cleaning is required in your home and your clothing and household items can be washed as usual. You do not have to do anything special with eating utensils or crockery.

What are health services doing about Candida auris?

The Health Department of WA has put several processes in place to control the spread of C. auris including ensuring:

• laboratories have systems in place to test for C. auris 
• patients who may have a risk of carrying C.auris are identified on admission to hospital and are screened
• all cases of C.auris identified in WA are reported to the Department of Health
• our hospitals have procedures in place to manage patients identified with C.auris 
• our hospitals have procedures for the cleaning and disinfection of equipment and patient rooms with products which can kill C. auris.

More Information

• If you are in hospital, you can ask to speak to the infection prevention control nurse.
• See your doctor.
• Ring healthdirect Australia on 1800 022 222.

Remember

• Candida auris is very uncommon in Australia.
• Candida auris is resistant to many powerful antifungal medications.
• Candida auris can spread from person to person through contact with infected people or people who carry the fungus without it causing infection within themselves.
• Hand hygiene is a simple but very effective measure that stops the spread of germs.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.