Candida Auris Screening

Overview

Ampath now offers Candida auris colonisation screening using two modalities:

1. Culture-based screening
2. PCR-based screening

The choice of screening criteria should be determined by the hospital or infection prevention and control (IPC) team.

Who Should Be Screened for C. auris Colonisation?

Screening is recommended for individuals meeting one or more of the following criteria:

Close healthcare contacts of a newly identified C. auris case

• Roommates or neighbouring patients in shared rooms or wards
• All patients in high-risk open units (e.g. ICU), especially with ongoing transmission

Positive screen for carbapenemase-producing Enterobacterales (CPE)

• C. auris co-colonisation is frequently seen in these patients

Recent hospital or long-term care facility admission

• Particularly if the facility is known to harbour C. auris

Admission to high-risk units

• Such as ICU or oncology units
• Especially before invasive procedures or mechanical ventilation

Specimen Collection Guidelines

For all patients, the axilla and groin must be swabbed. This is the most consistently colonised site.

Specimens by Type:

Culture-based Screening

• Swab sites:
  • Left and right axilla
  • Left and right groin
• Urine: Preferred third specimen
  • If urine unavailable, submit swab from an alternate site

PCR-based Screening

• Swab sites:
  • Left and right axilla
  • Left and right groin
• Additional swab options (if urine not submitted):
  • Anterior nares
  • Wounds
  • External ear canal
  • Catheter exit sites
  • Rectum

Swabbing technique:

• Swab each site up and down at least five times to collect sufficient material.

Maximum of 3 specimens per patient:

1. Specimen 1 (swab): Bilateral axilla
2. Specimen 2 (swab): Bilateral groin
3. Specimen 3:
   • Culture-based: Urine (preferred)
   • PCR-based: Alternate site swab if urine unavailable

Test Comparison Summary

Culture-based C. auris Screening

• Specimen type:
  • Gel swabs (axilla + groin)
  • Urine
• Turnaround time: 48 hours
• Mnemonic: CAURSC‍

PCR-based C. auris Screening

• Specimen type:
  • Dry swabs (axilla + groin)
  • Alternate third site as needed
• Turnaround time: 24 hours
• Mnemonic: CAURISPCR