Guidance

Notification, reporting and information sharing

Updated 19 March 2025

Recommendation

Submit electronic reports of all colonising and infecting Candidozyma auris (C. auris) episodes to the UK Health Security Agency (UKHSA) via the Second Generation Surveillance System (SGSS).

There is known under-ascertainment of C. auris cases, particularly colonisations and suspected under-reporting of C. auris outbreaks. Subject to Parliamentary approval, from April 2025, C. auris will be listed as a notifiable causative agent under schedule 2 of the Health Protection (Notification) Regulations 2010.

Laboratories (NHS, independent sector and UKHSA) are asked to include all C. auris isolates, both colonisations and infections, in their reporting to the SGSS and to ensure the correct mapping of the species code to help reporting via Laboratory Information Management System.

If a patient dies and the cause of death is attributable to C. auris, this should be included in the death certificate.

Outbreak notification

Recommendations

Conduct an incident investigation when a novel, suspected or confirmed healthcare-associated case of C. auris is identified and consider convening an Incident Management Team.

Declare an outbreak when 2 or more C. auris cases are identified that are linked in time and place, and:

• there is a high index of suspicion for local transmission and/or
• cases emerge without either a history of an overnight stay in a healthcare facility abroad or links to other affected hospitals or units in the UK

Timely notification of outbreaks and effective information sharing is required to facilitate risk assessment and timely IPC interventions across relevant health system partners. For IPC purposes, a case is considered an occurrence of either C. auris colonisation or infection in an individual. Due to the risk of transmission within healthcare facilities and the potential clinical impact of this organism, precautions should be instigated as soon as a single case of C. auris is identified or suspected.

In addition, trigger an appropriate incident investigation when a novel, suspected or confirmed healthcare-associated case of C. auris is identified. This should include effective IPC measures, contact identification and screening, with consideration given to convening an incident management team.

Organisations experiencing an outbreak of C. auris are asked to:

• notify their local UKHSA health protection team (HPT) in a timely manner
• share information regarding individual colonisation or infection status with receiving hospitals on patient transfer
• share information regarding hospital outbreak status via NHS and independent hospital networks and/or directly with relevant organisations through established channels

It is expected that affected organisations share information with relevant NHS and independent hospitals and organisations (including commissioners, providers and regulatory bodies as appropriate) within their locality and referral networks. IPC teams should share information directly with receiving hospitals when patients are being transferred from any affected units. Proactive information sharing is important for risk assessment, mitigation and to facilitate appropriate screening and implementation of IPC measures as appropriate. This is especially relevant for C. auris outbreaks where colonised cases make up the majority of cases and proactive measures may be required to promptly detect and manage emergent cases and interrupt transmission.

UKHSA HPTs can offer support in investigation and risk mitigation of complex outbreaks, as well as with UKHSA’s national specialist microbiology, IPC, and reference microbiology services. Information on how to contact your local HPT is available online.