Deadly fungus Candida auris is spreading rapidly in U.S. hospitals, threatening vulnerable patients with a drug-resistant infection that kills more than one in three people infected.
Key Insights
- Candida auris is a deadly, drug-resistant fungus that has been declared an “urgent threat” by the CDC, with infection rates doubling annually since its first U.S. detection in 2016.
- The fungus has a mortality rate of 30-60% among infected individuals, primarily affecting already-hospitalized patients with catheters, breathing tubes, or compromised immune systems.
- Cases have surged in Georgia and Florida healthcare facilities, with California reporting the highest number at 1,566 infections.
- Standard hospital disinfectants are often ineffective against C. auris, which can survive on surfaces for weeks and spread through contaminated medical equipment.
- Effective infection control requires specialized EPA-registered disinfectants, strict hand hygiene, patient isolation, and careful equipment cleaning protocols.
Rising Threat in American Hospitals
Candida auris, a deadly drug-resistant fungus, is rapidly spreading through hospitals and long-term care facilities across the United States. First identified domestically in 2016, cases have more than doubled annually, reaching 4,514 clinical cases in 2023, according to CDC data. California has reported the highest infection numbers with 1,566 cases, while Georgia and Florida have experienced concerning recent outbreaks. The fungus poses particular danger to already-vulnerable hospital patients with compromised immune systems or invasive medical devices.
The CDC officially classified C. auris as an “urgent threat” in 2023 due to its remarkable resistance to multiple antifungal drugs, its ability to persist on surfaces, and its high mortality rate. The fungus can colonize patients without symptoms for months, making detection difficult until severe infections develop. What makes C. auris particularly problematic is its resilience against standard hospital cleaning practices, requiring specialized disinfection protocols and vigilant infection control measures.
How Candida auris Spreads
C. auris transmits primarily through direct contact with colonized or infected individuals and contaminated surfaces or equipment. The fungus can survive on plastic surfaces for up to four weeks and withstand many standard cleaning agents. Unlike other fungal infections, C. auris spreads easily in healthcare settings, particularly among patients with extended hospital stays. High-risk patients include those with central venous catheters, urinary catheters, mechanical ventilators, or feeding tubes.
“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” said Dr. Meghan Lyman of the CDC in a statement addressing the growing crisis.
The CDC reports that C. auris can be found on both high-touch surfaces near patients and more distant areas throughout hospital rooms. Most concerning is the fungus’s ability to resist quaternary ammonia compound disinfectants commonly used in healthcare facilities. This resistance requires hospitals to implement more specialized cleaning protocols and restrict the movement of colonized patients to prevent facility-wide outbreaks.
Infection Control Strategies
Hospitals battling C. auris must implement comprehensive infection control strategies including patient screening, isolation of positive cases, and strict environmental cleaning protocols. Before you or a loved one gets admitted to a hospital, ask your doctor if your healthcare facility is following the CDC recommendation for battling C. auris. The CDC recommends using only EPA-registered hospital-grade disinfectants effective against C. auris (List P) or, if unavailable, products effective against Clostridioides difficile spores (List K). Standard alcohol-based hand sanitizers remain effective for hand hygiene unless hands are visibly soiled.
“Most of the patients that get infections with Candida auris are themselves pretty sick to start with. This is something that can push people over the edge and become life-threatening,” explained Stuart Cohen, chief of infectious diseases at UC Davis Health. “The goal is, first and foremost, to keep the people in your hospital safe. When somebody comes in for a procedure, they’re not expecting to go home with a life-threatening illness.”
Healthcare facilities are implementing patient isolation practices, with infected individuals ideally placed in single rooms or cohorted with other C. auris patients when necessary. Medical equipment sharing is discouraged, and when unavoidable, requires thorough disinfection between patients. Some facilities have begun supplementing traditional cleaning with UV irradiation or vaporized hydrogen peroxide systems, though these “no-touch” methods are considered supplementary rather than replacements for manual disinfection.
Protecting Vulnerable Patients
With mortality rates estimated between 30-60% among infected individuals, protecting vulnerable patients remains the primary concern for healthcare facilities. Patients most at risk include those with extended hospital stays, invasive medical devices, recent antibiotic or antifungal medication use, and underlying health conditions that compromise immune function. Healthcare workers must wear gowns and gloves when interacting with colonized patients, following strict Contact Precautions or Enhanced Barrier Precautions based on facility type.
Currently, no specific intervention is known to eliminate C. auris colonization in patients, though some facilities are exploring the use of chlorhexidine bathing, which has shown laboratory activity against the fungus. The CDC emphasizes that communication between facilities during patient transfers is crucial, as colonized patients can unknowingly introduce the pathogen to new healthcare environments. Early identification through active surveillance and laboratory testing remains essential for containing outbreaks.
As C. auris continues to spread across the United States, healthcare facilities in Georgia and Florida face particular challenges in containing recent outbreaks. Ongoing research into more effective antifungal treatments and disinfection methods offers hope, but for now, strict adherence to infection control protocols remains the primary defense against this emerging and dangerous pathogen.
