Candida auris (C. auris) Reporting

C. auris Investigation Form (pdf)

Cases of Candida auris (C. auris) should be reported within 1 working day to the local or regional health department. If the jurisdiction is unclear, call a DSHS Regional HAI Epidemiologist or Emerging and Acute Infectious Disease Unit (EAIDU) at 512-776-7676 for assistance.

As required by the Texas Administrative Code (TAC), all Candida auris isolates must be submitted to the DSHS laboratory.

Texas Department of State Health Services
Laboratory Services Section
1100 West 49th Street
Austin, Texas 78756-3199

Clinical Case Definition

When found in a clinical culture, C. auris can represent an infection or colonization. There is no set clinical case definition for C. auris as it can cause many types of symptoms.

Laboratory Confirmation

Candida auris: Candida auris from any body site/source that is laboratory confirmed.

  • Confirmatory laboratory evidence:
    • Detection of C. auris from any body site using either culture or a culture independent diagnostic test (CIDT) (e.g., Polymerase Chain Reaction [PCR]).
  • Presumptive laboratory evidence:
    • Detection of C. haemulonii from any body site using a yeast identification method that is not able to detect C. auris, AND
    • Either the isolate/specimen is not available for further testing, or the isolate/specimen has not yet undergone further testing.

(Note: When additional test results are available, case re-classification may occur, including making this a non-case.)

Case Classification

Candida auris case, clinical

Public Health jurisdiction may consider stratifying clinical cases as invasive vs non-Candida auris (C. auris) invasive.

  • Confirmed: Person with confirmatory laboratory evidence from a clinical specimen collected for the purpose of diagnosing or treating disease in the normal course of care. This includes specimens from sites reflecting invasive infection (e.g., blood, cerebrospinal fluid) and specimens from non-invasive sites such as wounds, urine, and the respiratory tract, where presence of C. auris may simply represent colonization and not true infection.
  • Probable: Person with presumptive laboratory evidence from a clinical specimen collected for the purpose of diagnosing or treating disease in the normal course of care and evidence of epidemiologic linkage. A clinical specimen includes specimens from sites reflecting invasive infection (e.g., blood, cerebrospinal fluid) and specimens from non-invasive sites such as wounds, urine, and the respiratory tract, where presence of C. auris may simply represent colonization and not true infection.

Candida auris case, colonization/screening

  • Confirmed: Person with confirmatory laboratory evidence from a swab collected for the purpose of screening for C. auris colonization regardless of site swabbed. Typical colonization/screening specimen sites are skin (e.g., axilla, groin), nares, rectum, or other external body sites. Swabs from wound or draining ear are considered clinical.

  • Probable: Person with presumptive laboratory evidence from a swab collected for the purpose of screening for C. auris colonization regardless of site swabbed. Typical colonization/screening specimen sites are skin (e.g., axilla, groin), nares, rectum, or other external body sites. Swabs from wound or draining ear are considered clinical. 

Criteria to distinguish a new case of this disease or condition from reports or notifications that should not be enumerated as a new case for surveillance

  • A person with a clinical case should not be counted as a colonization/screening case thereafter (e.g., a patient with a known infection who later has colonization of skin is not counted as more than one case).

  • A person with a colonization/screening case can be later categorized as a clinical case (e.g., a patient with a positive screening swab who later develops bloodstream infection would be counted in both categories).

C. auris Investigation Form (pdf)