Surveillance of C. auris and Other Potentially Pathogenic Yeast Among Anesthesia Workspace Reservoirs, Multicenter Study

The emergence of multidrug-resistant (MDR) Candida auris has raised concern about fungal healthcare-associated infections in perioperative and critical care settings. We evaluated anesthesia workspaces to identify high-risk reservoirs and inform optimization of infection prevention practices.

We conducted a prospective multicenter observational study of patients across 11 geographically dispersed U.S. hospitals from March 2023 to July 2025. A total of 6,074 reservoirs were sampled during 605 surgical cases and 273 consecutive operating room case pairs to detect C. auris and other potentially pathogenic yeast, including C. pseudohaemulonii, C. vulturna, C. diddensiae, C. metapsilosis, and Naganishia diffluens.

No anesthesia workspace reservoirs tested positive for C. auris (95% CI 0%-0.61% for surgical cases and 0-1.34% for case pairs). Other potentially pathogenic yeast (24 isolates) were detected in 1.16% (7/605) of cases. Most isolates were recovered from patient skin (92%), with fewer from environmental surfaces (4%) and practitioner hands (4%). Potential transmission patterns reflected known C. auris epidemiology, including patient-to-environment and patient-to-patient spread.

Outside outbreak settings, the anesthesia workspace for the studied population appears to be a low-risk reservoir for C. auris, making routine empirical environmental interventions such as high-dose ultraviolet-C irradiation difficult to justify. Surveillance for other potentially pathogenic yeast may provide a more practical approach to guide targeted infection prevention efforts.