There have already been more than 3,400 cases of Candida auris (C. auris) in 27 states so far this year, according to data released by the Centers for Disease Control and Prevention (CDC). California’s seen the most infections, 873, with Texas No. 2 at 433. C. auris is an emerging fungus that can cause severe infections that are often resistant to multiple antifungal medications. This fungus spreads most often among patients in healthcare facilities.
Erica Kaufman West, MD, is an infectious diseases physician in Indiana. She also is director of infectious diseases in the Department of Medicine, Science and Public Health at the American Medical Association (AMA). She took time for an interview to outline what patients should know about C. auris, how the fungus spreads, who is most at risk, what the symptoms are, and what steps you can and should take to protect yourself and your loved ones.
What is C. auris?
This fungus can cause severe illness and spreads easily in healthcare facilities.
“Cases have been rising, in general, for close to 10 years. And so, this is not a new problem, but it is a growing problem,” Dr. Kaufman West said. “The rate of growth has slowed, but it's still growing. It became fairly exponential around 2018 or 2019—it just really started taking off. And in 2024, there were about 6,300 cases.”
How is C. auris spread?
Some patients carry the fungus on their skin and other parts of their body without it causing symptoms. This is called colonization.
“We all have bacteria and yeast that live on our skin as our normal flora. It just means bacteria that just live there and don't do any damage,” Dr. Kaufman West explained. “That's totally normal. It's healthy. It helps protect against other bacteria that might be trying to move in. It just sort of keeps everything in a nice balance. So, everybody's colonized with many things. Nobody has nothing on their skin. We all have stuff on our skin, in our ears, between our toes—and that's fine.”
“The problem,” Dr. Kaufman West said, “is if you become colonized with something that is multidrug-resistant, meaning there's not a lot of medications to treat it, and then you get sick with that—it makes it really difficult to treat.” That’s when something gets called a superbug.
To help prevent further resistance to the medications needed to effectively manage C. auris, only patients with signs or symptoms of C. auris infection should be treated. There is no clear, effective decolonization protocol yet.
What are the symptoms of C. auris?
These depend on where the body is being hit with C. auris infection and how severe it is. Symptoms can be a lot like infections caused by bacteria, such as fever or chills.
“The most common infection is when it gets into the bloodstream, via a catheter or indwelling line,” said Dr. Kaufman West. “That can cause fevers, chills, low pressure and confusion. Patients typically get put on antibiotics, but if someone isn’t getting better, then it’s time to think about a fungal infection, such as C. auris.”
Who is most at risk for C. auris infection?
“The people most affected by Candida auris are those spend a lot of time in healthcare facilities,” Dr. Kaufman West said. “It’s people who have chronic conditions that require them to either stay in an extended care facility for several months after an initial hospitalization or someone who lives in a skilled nursing facility on and off because of conditions that might flare up.”
At especially high risk are patients who are using a:
- Breathing tube.
- Feeding tube.
- Catheter in a vein.
- Urinary catheter.
Also at risk are patients who have one prolonged hospitalization after another. “These are the folks that tend to get this, most likely because they are exposed to other people who tend to get this by virtue of being in those facilities,” Dr. Kaufman West said.
What can you do to help prevent the spread of C. auris?
When visiting a loved one in the hospital, nursing home, skilled nursing facility or rehabilitation facility— especially someone who is using a breathing, feeding or other kind of medical device—use an alcohol-based hand sanitizer to clean your hands before entering the room or touching the patient.
Also, ask your doctor—or your loved one’s physician—what if any other steps you can or should be taking to prevent the spread. Facilities may have particular precautions in place based on other infectious diseases that are circulating or your loved one’s specific health circumstances.
What to ask your doctor about C. auris?
If you or a loved one is infected with C. auris, your physician should follow advice from the CDC and others regarding recommended treatments, and your doctor should consider consulting with an infectious diseases physician.
In terms of prevention, ask the doctor managing your loved one’s care in a hospital or any other facility about what screening procedures are in place to identify C. auris colonization and prevent its spread.
“It’s worth understanding what they screen for, and if someone tests positive, what it is that you need to do, especially if you’re going to be the one taking that patient home,” Dr. Kaufman West said. “Do you need to make sure they have their own room at home? Their own bathroom?”
Asking such questions “can give you information, from a caregiver standpoint, on how to help best take care of the patient.”
Learn more about Project Firstline, a collaborative effort led by the CDC to provide infection-control training to the more than 6 million physicians and health professionals in the U.S., as well as members of the public health workforce. The AMA is partnering with the CDC in this initiative.
Explore further with the AMA’s What Doctors Want Patients to Know™ series, which gives physicians a platform to share what they want patients to understand about today’s healthcare headlines and how to take charge of their health through preventive care.
