Table 1 Key points for C. auris prevention and control by the European Centre for Diseases Prevention and Control (ECDC) and Centers for Disease Control and Prevention (CDC)

Correct identification (MALDI-TOF; DNA sequencing of the D1/D2 domain);

Clinicians and microbiologists alertness;

Notification and retrospective case-finding

Correct identification (MALDI-TOF; molecular methods)

Confirmed isolates of C. auris should be reported to local and state public health officials and to CDC

Good standard infection control measures (including environmental cleaning, reprocessing of medical devices and patient isolation) and prompt notification

Infection control measures:

• Placing the patient with C. auris in a single-patient room and using contact precautions

• Emphasizing adherence to hand hygiene

• Cleaning and disinfecting the patient care environment (daily and terminal cleaning) with recommended products

• Screening contacts of newly identified case patients to identify C. auris colonization

Early identification of carriers by using active surveillance cultures (sites considered for sampling include nose/throat, axilla, groin, rectum, insertion sites of venous catheters; clinical samples such as urine, feces, wound drain fluid, and respiratory specimens)

Screening should be performed to identify colonization among potentially epidemiologically linked patients, including:

• Current roommates

• Roommates at the current or other facilities in the prior month (even if they have been discharged from the facility)

Screening for C. auris should be done using a composite swab of the patient’s axilla and groin (sites of consistent colonization). Patients have also been found to be colonized with C. auris in nose, external ear canals, oropharynx, urine, wounds, and rectum.

Establish the source of the outbreak (epidemiological investigation, cross-sectional patient screening and environmental sampling); prevention of inter-hospital and cross-border transmission

Enhanced control measures to contain outbreaks (such as contact precautions, single room isolation or patient cohorting, and dedicated nursing staff for colonized or infected patients)

All laboratories, especially laboratories serving healthcare facilities where cases of C. auris have been detected, should:

• Review past microbiology records to identify cases of confirmed or suspected C. auris

• Conduct prospective surveillance to identify C. auris cases in the future

• Consider screening close contacts of patients with C. auris for presence of colonization

Education and practice audits (for healthcare workers and contacts)

Education of all healthcare personnel, including staff working with environmental cleaning services about C. auris and need for appropriate precautions;

Monitor adherence to infection control practices

Antifungal stewardship

Antibiotic and antifungal stewardship