Fungal Disease Awareness Week: Take Action to Protect Patients and Residents Against Candida auris
This message is being sent to infection preventionists, local and Tribal health department staff, public health nurses, Local health officers, Tribal health directors, and Division of Quality Assurance: Notifications and Updates.
September 16–20 is Fungal Disease Awareness Week (FDAW), a national yearly observance that raises awareness of fungal diseases and shares ways to reduce their impact. For FDAW 2024, the Wisconsin HAI Prevention Program encourages public health and health care partners to take action to protect patients and residents against Candida auris (C. auris), a fungus that can cause severe illness and spread easily in health care settings.
Background information on C. auris and action steps for protecting patients and residents in health care facilities are included below.
About C. auris
C. auris is a fungus, specifically a yeast, that is often resistant to multiple antifungal drugs. Certain people are at higher risk for C. auris including those:
- With open wounds.
- With weakened immune systems or chronic health conditions.
- Who have received lots of antibiotics.
- Who require invasive medical devices (such as breathing or feeding tubes, urinary catheters, or central venous catheters).
- Who frequently receive health care.
- With a history of living in congregate settings.
- Who have received health care outside of Wisconsin or abroad.
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People who are infected and colonized with C. auris can spread it to other people, surfaces, or objects in their environment. C. auris can also be spread by the hands or clothing of health care personnel. C. auris can spread rapidly in health care settings and be difficult to eliminate since the organism can live on skin and in the environment for months.
Increasing C. auris activity
The first case of C. auris was identified in Wisconsin in early 2022. Cases have since been detected in the Southern, Southeastern, and Northeastern regions of the state.
Wisconsin is seeing increasing activity of reportable multidrug-resistant organisms (MDROs) including C. auris. Wisconsin C. auris cases more than tripled from 2022 to 2023. In addition, the number of nationally reported clinical cases of C. auris increased nearly five-fold from 2019 to 2022, according to data recently updated by the CDC (Centers for Disease Control and Prevention).
Action steps for health care facilities
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Utilize colonization screening to rapidly identify C. auris and other targeted MDROs. Colonization screening refers to the process of testing or screening someone for the presence of a specific MDRO.
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A health care facility may conduct response-driven screening after identifying a patient or resident who is infected or colonized with a targeted MDRO to determine if other patients or residents in the facility are also colonized. See frequently asked questions on MDRO colonization screening in health care facilities (also available in Spanish) for additional information.
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A health care facility may choose to conduct admission screening of patients or residents who have risk factors for C. auris or another targeted MDRO such as a history of hospitalization abroad or history of living in a congregate living setting, to identify MDROs at the time of admission.
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The Wisconsin State Laboratory of Hygiene offers fee-exempt colonization testing supplies to Wisconsin health care facilities. For more details on colonization screening, please reach out to the Wisconsin HAI Prevention Program.
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Use appropriate precautions when working with patients and residents. All health care facilities must use standard precautions for all patient or resident care encounters.
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Hospitals are strongly encouraged to use contact precautions in addition to standard precautions when caring for patients who are colonized or infected with C. auris, or another targeted MDRO. if conducting colonization screening, the use of empiric contact precautions is recommended while screening results are pending.
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Nursing homes are strongly encouraged to use enhanced barrier precautions (EBPs) in addition to standard precautions when:
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Caring for residents with chronic wounds or indwelling medical devices regardless of their MDRO status.
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Caring for residents who are colonized or infected with C. auris or another targeted MDRO when contact precautions do not otherwise apply.
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Follow proper cleaning and disinfection processes. Health care and environmental services personnel should consult disinfectants' manufacturer’s instructions for use for any kill claims, contact times, and concentration specifications. Refer to the Environmental Protection Agency’s (EPA) List P for products that are effective against C. auris.
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Whenever possible, use single-use, disposable, non-critical equipment or dedicate equipment for patients or residents colonized or infected with C. auris or another targeted MDRO. If this is not possible, disinfect shared medical equipment between patients or residents.
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Increase the frequency of cleaning, with additional focus on high-touch surfaces and the colonized or infected patient's or resident's room.
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Practice proper hand hygiene. Health care personnel should perform hand hygiene throughout their shift. Patients or residents who are colonized or infected with C. auris or another MDRO should be educated and encouraged to perform hand hygiene routinely.
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Communicate patients’ or residents’ MDRO status and history. The CDC provides an Inter-Facility Information Control Transfer form to help assist in this communication. The Wisconsin Department of Health Services (DHS) highly recommends that health care providers flag a patient or resident’s electronic health record so that internal and external care providers can use proper precautions during health care encounters.
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A patient’s or resident’s MDRO status alone is not grounds to refuse their admission to a health care facility. For questions regarding patient or resident management and MDROs, please contact your regional infection preventionist.
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Implement an antimicrobial stewardship program. An effective antimicrobial stewardship program can help address the overarching problem of emerging antibiotic-resistant bacteria by reducing the overprescribing of antibiotics. Learn more about stewardship programs based on care setting at, Antimicrobial Stewardship: Resources for Health Care Providers.
Department of Health Services resources
You can find additional information on FDAW and other fungal diseases on the CDC website.
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