Candida auris (C. auris): Tackling the drug-resistant fungal threat

Candida auris is rapidly becoming one of healthcare’s biggest challenges. This drug-resistant fungus has gained significant attention from medical professionals worldwide, and for good reason.

What sets C. auris apart is its triple threat: it resists multiple drugs, survives on surfaces for extended periods, and puts vulnerable patients at risk. In healthcare facilities, where maintaining a sterile environment is crucial, C. auris makes infection control even more challenging [1].

Unlike common fungal infections, C. auris poses a serious risk in hospitals and long-term care facilities, where it stubbornly clings to surfaces and medical equipment.

The World Health Organization (WHO) raised a red flag about C. auris in October 2022, ranking it among their most critical health threats [2]. This wasn’t bureaucratic box-checking—it was a stark warning about a fungus that poses serious risks, particularly to people with weakened immune systems. The WHO’s designation serves as both an urgent alert to healthcare providers and a call to action for research funding.

But C. auris wasn’t always on our radar. Despite its current notoriety, this fungal invader only recently emerged as a global health concern—and its origin story reveals why scientists are so troubled by its rapid rise.

C. auris was first discovered in Japan. Scientists first identified it in 2009 from an ear sample. But this discovery was just the beginning. The fungus quickly made its presence known in healthcare facilities across Asia, with India and South Korea reporting infections shortly after [3,4].

By 2012, C. auris had crossed continents, showing up in South America. Europe got its first case in 2013 and the United States in 2016 [4-6].

So, in just 16 years since its discovery, C. auris has spread to at least 50 countries across every region where the WHO monitors disease. This worldwide presence shows why health officials remain deeply concerned [6].

How did the fungus show up in different parts of the world so quickly? The years 2012 to 2013 may mark a crucial turning point—before then, four genetically distinct versions of C. auris, known as clades, were quietly emerging in different parts of Asia, South Africa, and South America [4].

After that, these separate strains began rapidly spreading to other countries, hitchhiking along human travel routes. The boom in international trade and travel likely helped fuel the spread as well.

C. auris has become a disruptive force in hospitals and long-term care facilities worldwide, where clusters of hospital-acquired infections continue to emerge. But what makes healthcare providers uneasy is its impact on survival rates.

Determining the exact death toll from C. auris isn’t straightforward. Many patients who develop severe infections are already fighting other serious conditions—making it difficult to identify the precise cause of death. Yet a 2024 literature review by Kim et al. paints a grim picture: when C. auris enters the bloodstream, 30% to 60% of patients don’t survive [7].

Additionally, the financial impact cuts deep. In the United States alone, fungal diseases cost the healthcare system over $7.2 billion in 2017, with Candida infections among the most expensive to treat. These numbers likely fall short of reality—many C. auris cases slip past detection. Now hospitals must invest heavily in upgraded infection control measures, adding another layer of cost to fight this rising threat [8].

C.auris spreads in persistent ways that challenge even the most rigorous infection control measures. In hospitals and care facilities, the fungus moves from person to person through direct contact, lurks on medical equipment, and travels on the hands of healthcare workers [9].

Here’s what makes it particularly challenging: you don’t need to be sick to spread C. auris. People can carry the fungus on their skin without showing any symptoms, and still pass it to others. This is called ‘skin colonization’ and it can continue for weeks or even months, making it even harder to control the spread [4].

Once C. auris finds its way into a healthcare facility, it’s not going down without a fight. The fungus sticks to everything from bedrails to doorknobs and medical devices. Even thorough cleaning isn’t always enough to eliminate it completely—making it one of the most difficult pathogens for healthcare facilities to control [3,4].

Hospitals and long-term care facilities see the highest rates of C. auris infections, particularly among patients with weakened immune systems. Those with ongoing health conditions like diabetes, kidney disease, or severe infections face an increased risk of developing serious complications [10].

The risk goes up significantly for patients who need medical devices like catheters or feeding tubes. These devices can act like highways for C. auris—giving it a direct route into the body [10].

Combining a weakened immune system with these medical devices creates a perfect storm for C. auris to cause serious infections.

Spotting a C. auris infection isn’t always straightforward. The first signs often include fever and chills that don’t go away, even with standard antibiotics. This is because C. auris can switch from harmlessly living on your skin to causing an active infection [10].

For patients already dealing with other illnesses, C. auris can become more dangerous by entering the bloodstream. Once there, it can spread to major organs and cause serious complications, and in extreme cases, death [10].

Diagnosing C. auris presents a major challenge in healthcare settings. Standard lab tests often mistake it for other types of yeast, which can lead to delays in proper treatment. While specialized tests exist to accurately identify C. auris, they’re not available everywhere [6].

The lack of a universal testing method creates another hurdle. Not all healthcare facilities have access to the specialized knowledge needed to detect C. auris, and in many parts of the world, the expensive diagnostic equipment is out of reach. This problem gets worse in regions where awareness is low and healthcare workers haven’t received the necessary training to identify the infection accurately [6].

Getting the right treatment for C. auris is challenging because this fungus resists many common medications. The typical go-to antifungal drug, fluconazole, doesn’t work in nearly 90% of cases. Even more concerning, C. auris shows resistance to many other common antifungal medications [1,6].

Currently, doctors typically start treatment with a class of drugs called echinocandins—such as micafungin, caspofungin, or anidulafungin—which have shown better success rates. But even these medications aren’t foolproof. In some rare cases, C. auris has developed resistance to these drugs too [1,6].

When echinocandins don’t work or the infection persists, healthcare providers may switch to or add liposomal amphotericin B to the treatment plan. This approach highlights how doctors often need to adjust and adapt their strategy to fight this stubborn infection.

Basic hygiene goes a long way in protecting against C. auris. Outside of hospitals, regular handwashing with soap and water helps prevent its spread, just as it does with many other germs.

Healthcare facilities need to take more intensive measures to control this persistent fungus. Staff follow strict protocols that include wearing gloves and using specific disinfectants proven to kill C. auris. Many hospitals have also stepped up their cleaning schedules and implemented screening programs to catch potential outbreaks early.

Success in preventing C. auris spread depends on everyone doing their part—healthcare workers, patients, and visitors all play a role in following these safety measures to protect those most at risk.

Can a Candida auris infection be cured?

C. auris infections are treatable, especially when caught early. With the right antifungal medications, many patients recover successfully. 

However, treatment becomes more challenging because the fungus may be misdiagnosed or resistant to common medications. In particular, it is difficult to treat patients with C.auris infections who already have weakened immune systems or other serious health conditions.

How to avoid a C.auris infection?

The best defense against C. auris starts with basic but important steps. Regular handwashing makes a big difference, especially in healthcare settings. If you’re visiting a hospital or care facility, follow their hygiene guidelines and avoid touching surfaces unnecessarily.

Healthcare facilities play an even bigger role in prevention. They need specific disinfectants that work against C. auris, along with thorough cleaning protocols. It’s also advisable to test patients regularly to catch the fungus early before it has a chance to spread.

Is a Candida auris infection permanent?

C. auris infections don’t often last forever, but recovery hinges on several critical factors. Your immune system’s strength, timing of detection, and the presence of other health conditions like diabetes or cancer all influence how well treatment works. 

While most patients can overcome the infection with proper care, its resistance to multiple drugs means some people need longer or repeated treatments—especially those with weakened immune systems or medical devices like central lines.

C. auris has pushed healthcare to strengthen its approach to infection control. Traditional methods need reinforcement—and in some cases, updating—to effectively combat this persistent fungus.

The fight requires coordinated effort from researchers developing new treatments and healthcare workers strengthening infection protocols. Each advance against C. auris, whether it’s a more sensitive detection method or a more effective cleaning procedure, improves the response to this pathogen.

For now, success relies on consistent vigilance: strict infection control, rapid outbreak response, and continued education. These efforts protect patients while preparing healthcare systems for future challenges in infection control.

GIDEON is one of the most well-known and comprehensive global databases for infectious diseases. Data is refreshed daily, and the GIDEON API allows medical professionals and researchers access to a continuous stream of data. Whether your research involves quantifying data, learning about specific microbes, or testing out differential diagnosis tools– GIDEON has you covered with a program that has met standards for accessibility excellence.

Learn more about fungal infections on the GIDEON platform.