Recent reports1 highlighting the continuing increase and geographic spread of Candida auris — a multidrug-resistant fungus that is moving between healthcare facilities — have raised the question of whether healthcare workers could be infected or colonized with the emerging pathogen.
It is highly unlikely, but the risk is not zero.
The question is understandable because fungi in general have captured public attention, in part due to a popular post-apocalyptic zombie TV show based on a fact in nature: the bizarre ability of cordyceps fungi to turn ants into automatons, robotically climbing plants and distributing spores. Why could this not happen to humans? Ants are not warm-blooded.
C. auris typically infects and colonizes frail patients with underlying conditions in skilled nursing facilities or long-term care. Outbreaks also can occur in hospitals, so it is important for healthcare workers in all settings to wear appropriate personal protective equipment and wash hands as recommended to avoid “transient” colonization that could spread C. auris to another patient. Although there was some initial confusion because C. auris requires a stronger cleaning agent to remove from the environment, alcohol hand rubs work against the fungus, and hand hygiene will protect healthcare workers.
Transient colonization, as the name implies, is not the same as the long-term colonization in high-risk patients who also may require ventilators and intravenous lines. These patients can be asymptomatic for C. auris infection, but the resourceful fungi grow on their skin and can be spread to other patients by touch, fomites, or environmental contamination.
According to the CDC:
• “The risk of C. auris infection to otherwise healthy people, including healthcare personnel, is very low.”
• “In the United States, C. auris infection has primarily been identified in people with serious underlying medical conditions who have received multiple antibiotics, and who have had prolonged admissions to healthcare settings or reside in healthcare settings.”
• “Otherwise, healthy people do not seem to be at risk for C. auris infections but can be colonized on their skin.”
• “In one study3 involving a C. auris outbreak, colonization with C. auris was detected in <1% of healthcare personnel. Colonization was transient on the hands and in the nostrils.”
• “At this time, healthcare providers do not need to be tested for C. auris unless they are identified as a possible source of transmission to patients. Family members of healthcare personnel do not need to be tested for C. auris.”
- Lyman M, Forsberg K, Sexton DJ, et al. Worsening spread of Candida auris in the United States, 2019 to 2021. Ann Intern Med 2023;176:
489-495.
- Centers for Disease Control and Prevention. Candida auris. Healthcare professionals FAQ. Last reviewed April 9, 2021.
- Schelenz S, Hagen F, Rhodes JL, et al. First hospital outbreak of the globally emerging Candida auris in a European hospital. Antimicrob Resist Infect Control 2016;5:35.
