Hospitals screen for Candida auris (C. auris) by collecting a skin swab—usually from both armpits and the groin—and testing it for colonization, most often with real-time PCR. A positive screening result means the yeast was detected on the sampled skin; it does not, on its own, mean the patient has an active infection. Hospitals coordinate whom to screen and what precautions to use with public-health partners, based on exposure, local spread and facility circumstances.
What a screening test is looking for
Colonization means C. auris is present on the body, often without symptoms. A colonized patient can still spread the yeast in a healthcare setting, so screening helps a facility identify people who may need infection-prevention measures. CDC explains this rationale in its Screening Recommendations, updated October 1, 2026.
Screening is different from diagnosing infection. A screening swab looks for colonization at sampled skin sites. A clinical diagnostic specimen is evaluated when infection is suspected, and the organism must be accurately identified; treatment decisions may also require antifungal susceptibility testing.
How hospitals decide whom to screen
There is no single screening rule used for every hospital. Facilities may test targeted patients or conduct broader screening, depending on local C. auris prevalence or spread, a patient’s exposure and epidemiologic links, individual risk factors, facility characteristics and the purpose of testing. CDC encourages screening after a facility identifies its first case. The facility should coordinate its approach with local public-health partners.
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How the screening swab is collected
CDC’s recommended screening specimen is one composite swab rubbed over both axillae (armpits) and both groin areas. Sampling several skin sites with one swab gives the laboratory a specimen from the recommended locations; the procedure is performed by healthcare staff, not as a home test.
- Using one swab, make five back-and-forth passes over the left axilla and five over the right axilla.
- With the same swab, make five passes over each groin area.
- Place the swab in its collection tube and ship it promptly to the laboratory according to the collection product’s instructions.
See CDC’s C. auris Screening: Patient Swab Collection, updated June 26, 2026, for the procedure. CDC gives a nylon-flocked swab and a culture collection and transport system such as BD ESwab as an example; that example is not an endorsement. Other sites, including the nose and hands, have been studied, but the recommended standard screening specimen remains the axilla-and-groin swab.
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How laboratories detect colonization
For colonization screening, CDC prefers real-time PCR. It detects C. auris genetic material and is the fastest approach for public-health action, according to CDC’s Guidance for Detection of C. auris Colonization, dated October 1, 2026. Actual turnaround depends on the laboratory; there is no universal hospital turnaround time.
Culture is an alternative when PCR is unavailable. A swab can contain a mixture of yeasts, so a culture workflow must isolate the organism from that mixture to confirm its species. CDC’s described isolation procedures require validation by the laboratory under its applicable regulatory oversight; they are not FDA-cleared or FDA-approved tests. Hospitals may use different validated routes, so PCR and culture should not be treated as interchangeable in speed or laboratory requirements.
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What positive and negative results mean
A positive screening result
A positive result means C. auris was detected on the screening specimen and supports classifying the patient as colonized. It does not establish that the patient has an active infection. Because colonized people may transmit C. auris without symptoms, the result can still prompt infection-prevention action.
A negative result
A negative swab means the test did not detect C. auris in that specimen; it does not necessarily rule out colonization. In people already known to carry C. auris, colonization can persist for a long time and results may be intermittently negative. CDC does not recommend using repeat screening of known carriers to establish that precautions can end. No effective decolonization strategy is currently known.
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How a suspected infection is evaluated
When infection is suspected, clinical specimens follow a separate laboratory pathway. Symptoms and signs are nonspecific, so the result depends on accurate identification rather than assuming that a screening swab diagnoses disease. Traditional biochemical yeast-identification methods can misidentify C. auris. CDC’s Laboratory Information for C. auris, updated September 30, 2026, describes sequencing and mass spectrometry for identification and calls MALDI-TOF MS the most reliable method.
CDC recommends antifungal susceptibility testing for clinical cases to help guide therapy. The same CDC laboratory guidance notes that CLSI has not established C. auris-specific breakpoints; CDC’s tentative breakpoints are interim values based on expert opinion and breakpoints for related species. These details concern clinical cases, not interpretation of a colonization screen.
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What happens after a result
Laboratories should promptly alert the facility’s infection-prevention team to possible or confirmed cases and follow state and local reporting processes. CDC’s detection guidance says confirmed specimens should be reported to state and local health departments and CDC, and encourages submission of isolates to the AR Lab Network. Infection-control measures apply to colonization as well as infection; the facility and public-health partners determine operational steps under local policy.
For an individual patient, ask the hospital team whether the result is from a colonization screen or a clinical specimen and what facility precautions apply. Do not use a screening result alone to diagnose infection or stop precautions.
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