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Testing to Detect Candida auris Colonisation After Intrahospital Transfer From an Endemic Area, a Prospective

Laura Mezzogori1,2, Martina Bavastro1,2, Laura Magnasco2

  • 1Department of Health Sciences, University of Genoa, Genoa, Italy.

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|February 14, 2026
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Summary

A single negative Candida auris screening swab before transfer is insufficient to rule out colonization. Repeated screening within two weeks post-transfer is crucial for detecting colonization and preventing transmission.

Keywords:
Candida auriscandidemiacolonisationintensive care unitscreeningsurveillanceswabstransmission prevention

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Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Hospital Epidemiology

Background:

  • International guidelines lack clear recommendations for managing patients transferred from Candida auris endemic wards to non-endemic wards.
  • The optimal timing and number of screening swabs to exclude colonization remain unclear.

Purpose of the Study:

  • To evaluate the effectiveness of post-transfer screening protocols in detecting Candida auris colonization in non-colonized patients.
  • To determine the optimal screening strategy to prevent horizontal transmission of Candida auris.

Main Methods:

  • Prospective observational study of adult patients transferred from a Candida auris endemic ICU to non-endemic wards.
  • Real-time PCR screening of axilla/groin swabs performed on Days 0-1, 2-3 post-transfer, and weekly thereafter.
  • Patients considered sufficiently screened if ≥2 swabs were negative within 4 weeks post-transfer.

Main Results:

  • Of 440 non-colonized patients, 208 were sufficiently screened, with 16.3% testing positive for Candida auris post-transfer.
  • 7.1% of patients with a negative pre-transfer swab tested positive later.
  • Candida auris candidemia occurred in 11.8% of patients with newly detected post-transfer colonization.

Conclusions:

  • A single negative pre-transfer screening swab is inadequate for excluding Candida auris colonization.
  • Repeated screening within the first two weeks post-transfer is essential for accurate detection.
  • Effective screening protocols are vital to prevent further Candida auris transmission in healthcare settings.