Breaking the Chain of Infection: A Systematic Review of Environmental Decontamination of Candidozyma auris (2017–2025)

TL;DR

This paper reviews environmental decontamination methods for Candidozyma auris, a drug-resistant yeast, to prevent its spread in healthcare settings.

Contribution

The study systematically evaluates the efficacy of various disinfectants and no-touch methods against C. auris, including biofilms and dry-surface biofilms.

Findings

Chlorine-based and oxidizing disinfectants (like hydrogen peroxide) were most effective against C. auris.

Quaternary ammonium compounds (QACs) showed poor and variable performance.

UV-C light can help reduce C. auris but depends on dose and setup, while ozone results are inconsistent.

Abstract

Candidozyma auris is an emerging multidrug-resistant yeast that readily contaminates healthcare environments, persisting on dry surfaces and enabling transmission and difficult-to-control outbreaks. A systematic review of environmental hygiene interventions targeting C. auris was conducted, focusing on efficacy against planktonic cells and surface-associated biofilms (including dry-surface biofilms, DSB where available). PubMed and Scopus were searched for English-language records published from 1 January 2017 to 30 September 2025, and study selection followed PRISMA 2020. Thirty-six studies from nine countries met the inclusion criteria. These were predominantly laboratory efficacy evaluations using carrier/suspension or quantitative surface methods reporting log10 Colony Forming Unit (CFU) reductions; only seven studies assessed biofilm-associated C. auris. Across clades I–IV, chlorine-based disinfectants and oxidizing chemistries (hydrogen peroxide/peracetic acid formulations) most consistently achieved high-level reductions (often ≥ 5 log10 CFU) under label-relevant conditions. In contrast, products containing only quaternary ammonium compounds (QACs) frequently underperformed and demonstrated greater variability. No-touch methods, particularly 254 nm ultraviolet-C light (UV-C), provided meaningful adjunctive reductions, but were highly dependent on dose delivery and geometry, and evidence for ozone-based approaches was mixed. Limited data on C. auris DSBs suggest planktonic testing may overestimate real-world conditions and underscore the importance of endpoints, such as transfer prevention and regrowth suppression.

Figures