Improved Consistency of Candida auris Colonization Screening With an Anterior Nares and Hands Composite Sample

Candida auris colonization screening is often performed using bilateral axilla and groin composite swabs. However, re-screening results for the same patient are often inconsistent over time, complicating interpretation of results. To address this, we designed and evaluated screening using an anterior nares and hands composite collection strategy in a cohort of patients colonized with C. auris.

This study included patients colonized with C. auris and cohorted on a 30-bed unit. Separate axilla and groin swabs, and anterior nares and hands swabs were obtained simultaneously at 6 different time points and tested by polymerase chain reaction (PCR) and culture.

A total of 102 swabs (51 of each composite swab type) from 19 patients were collected. By culture, 35 (69%) axilla and groin swabs were positive compared with 45 (88%) anterior nares and hands swabs. With PCR, 41 (80%) axilla and groin swabs and 50 (98%) anterior nares and hands swabs were positive. By culture, 15 temporal inconsistencies were observed with axilla and groin as compared with one instance with anterior nares and hands. With PCR, 12 temporal inconsistencies were observed with axilla and groin compared with 2 instances with the anterior nares and hands.

We found more positives and consistent positivity for anterior nares and hands swabs by both culture and PCR, suggesting that these sources provide more reliable detection of C. auris colonization. Anterior nares and hands composite swabs provide an alternative screening approach for C. auris colonization screening that can improve test consistency.