Hospitals screen for Candida auris (C. auris) mainly by swabbing both armpits and groin, then testing the combined skin sample—usually with real-time PCR. A positive screening result indicates colonization, not necessarily an active infection. Hospitals use it to guide infection-prevention measures because a person without symptoms can still carry and spread the yeast in healthcare settings.
Why and whom hospitals screen
Screening looks for colonization: C. auris present on the body, often without symptoms. That is different from testing a clinical specimen to find the cause of a suspected infection. A carrier may still be relevant to transmission control, so hospitals can take precautions even when the patient feels well.
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There is no single screening rule for every hospital. Facilities may target patients with relevant healthcare exposure, epidemiologic links, or other risk factors, or conduct broader surveys depending on local spread, facility characteristics, and the purpose of testing. CDC encourages screening after a facility identifies its first case. Decisions should be coordinated with local public-health partners and follow local policy. CDC screening recommendations, updated October 1, 2026.
How the screening swab is collected
CDC recommends one composite skin swab covering both axillae (armpits) and groin. Sampling these areas is the recommended standard; other sites have been studied, but they do not replace the recommended collection.
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- Using one swab, make five back-and-forth passes over the left armpit and five over the right armpit.
- With the same swab, make five passes over each groin area.
- Place the swab in its collection tube and send it promptly to the laboratory according to the collection system’s instructions.
These are collection steps for healthcare staff, not instructions for home testing. CDC describes a nylon-flocked swab and a culture collection/transport system such as BD ESwab as an example, not an endorsement. CDC patient swab collection instructions, updated June 26, 2026.
How laboratories look for colonization
| Approach | What it does | What to know |
|---|---|---|
| Real-time PCR | Detects C. auris in a screening specimen. | CDC calls PCR accurate and the fastest method for results supporting public-health action. Actual turnaround depends on the laboratory. |
| Culture | Grows and isolates the organism from the mixed yeasts present on a patient swab so the species can be confirmed. | An option when PCR is unavailable. CDC’s described isolation procedures require validation by the laboratory under applicable regulatory oversight; they are not FDA-cleared or approved tests. |
Hospitals do not all use the same assay, route, or turnaround time. CDC’s guidance for detecting C. auris colonization, dated October 1, 2026, identifies real-time PCR as the preferred screening method. It states: “Real-time PCR is an accurate method for detecting C. auris and provides the fastest results for public health action.”
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What a positive or negative screen means
Positive: colonization detected
A positive screening swab means C. auris was detected at the sampled skin sites. By itself, it does not diagnose an active infection or show that the patient has symptoms. It does alert the care team that infection-prevention measures may be needed because colonized patients can spread the organism in healthcare settings.
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Negative: not detected in that sample
A negative result means the test did not detect C. auris in the collected specimen; it is not proof that a known carrier has cleared colonization. CDC notes that colonization can persist for a long time and that results may be intermittently negative. CDC does not recommend re-screening known carriers as a way to end precautions, and no effective decolonization strategy is currently known. CDC clinical overview, updated February 26, 2026.
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Screening is not the same as diagnosing infection
Colonization screening asks whether C. auris is present on a screening swab. When a patient has a suspected infection, clinicians and laboratories evaluate a clinical specimen separately. Signs of infection can be nonspecific, and correct identification matters because traditional biochemical yeast-identification methods may misidentify C. auris.
CDC describes MALDI-TOF mass spectrometry as the most reliable identification method; sequencing is another identification approach. For clinical cases, CDC recommends antifungal susceptibility testing to help guide treatment. CLSI has not defined C. auris breakpoints; CDC’s tentative breakpoints are interim values based on expert opinion and breakpoints for related species. CDC laboratory information for C. auris, updated September 30, 2026.
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What happens after a result
Laboratories should promptly notify the facility’s infection-prevention team about possible or confirmed cases. Confirmed specimens should be reported through state and local public-health processes and to CDC; CDC also encourages isolate submission to the AR Laboratory Network. Infection-prevention measures apply to colonization as well as infection. The facility and public-health team determine the operational steps under local guidance. Details are in CDC’s detection guidance and screening recommendations.
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