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Candida auris Surveillance, Qualitative, Real-Time PCR, Axilla/Groin, Nares
Test CodeCANAQ or 10153
Alias/See Also
C. auris, C auris
CPT Codes
87481
Preferred Specimen
1 composite groin/axilla swab collected in liquid Amies elution swab (ESwab™)
Minimum Volume
1 Eswab
Other Acceptable Specimens
1 composite nasal swab in liquid Amies elution swab ESwab
Instructions
Swab both the left and right axilla (armpit) skin surface targeting the crease in the skin where the arm meets the the body approximately 3-5 times. With the same swab used on the axilla, swab the left and right groin skin surface, targeting the skin where the thigh meets the trunk approximately 3-5 times.
Transport Temperature
Refrigerated
Specimen Stability
Room temperature: Unacceptable
Refrigerated: 14 days
Frozen: 30 days
Refrigerated: 14 days
Frozen: 30 days
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
No swab present • Swab without media • Gel Amies collection tube • Blood samples • Urine samples
Methodology
Real-Time Polymerase Chain Reaction
FDA Status
LDT
Setup Schedule
Tues. - Sat.
Report Available
2-3 days (from receipt at performing lab)
Limitations
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.
Reference Range
Not detected
Clinical Significance
This test detects Candida auris colonization as part of surveillance effort to identify nosocomial transmission. C. auris is a multidrug-resistant fungus and an emerging cause of infection in hospital/healthcare settings. The CDC has reported year-to-year increases in cases since C. auris was made a nationally notifiable disease.[1] Colonization is a risk factor for bloodstream infection (candidemia), and invasive infections (candidiasis).[2] The most common sites of colonization are the axilla (armpit) and groin, but the nares (nostrils) may also be colonized.[2]
Transmission of C. auris primarily occurs in healthcare settings through physical contact with contaminated surfaces or through person-to-person contact. Nosocomial transmission occurs via contaminated medical equipment, such as catheters or feeding tubes, and contributes to significant risk of infection among long-term patients in healthcare settings or intensive care units, and among people with serious underlying medical conditions.[2]
Detection of C. auris colonization may help reduce nosocomial transmission. The CDC recommends swabbing the axilla and groin and also identifies the nares (and hands) as collection sites having potential for improving the identification of colonized patients.[2] Processing and detection can involve either culture-based or real-time PCR (RT-PCR) methods. Culture-based methods are considered the gold standard because they allow for isolate recovery and susceptibility testing.[3] Culture-based methods also have 5- to 7-day turnaround times, which may be too long when rapid identification of C. auris is needed to implement public health measures to control the spread of infection.[4]
RT-PCR addresses some constraints of culture-based methods for detecting C. auris colonization. Species-specific RT-PCR can differentiate C. auris from other closely related species (e.g., Candida albicans, Candida glabrata) and in some cases can detect C. auris when culture does not.[5] Furthermore, RT-PCR can be performed much faster, with results generally available in 2 to 3 days.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Tracking Candida auris. Centers for Disease Control and Prevention. Updated March 3, 2026. Accessed April 14, 2026. https://www.cdc.gov/candida-auris/tracking-c-auris/
2. About Candida auris. Centers for Disease Control and Prevention. Updated February 26, 2026. Accessed April 14, 2026. https://www.cdc.gov/candida-auris/about/.
3. Detection and culture of fungi in clinical specimens. Blog. The Clinical and Laboratory Standards Institute. Updated January 13, 2021. Accessed April 14, 2026. https://clsi.org/resources/insights-blog/detection-and-culture-of-fungi-in-clinical-specimens/
4. Leach L, Zhu Y, Chaturvedi S. Development and validation of a real-time PCR assay for rapid detection of Candida auris from surveillance samples. J Clin Microbiol. 2018;56(2):e01223-01217. doi:10.1128/JCM.01223-17
5. Hsu C, Yassin M. Diagnostic approaches for Candida auris: a comprehensive review of screening, identification, and susceptibility testing. Microorganisms. 2025;13(7):1461. doi:10.3390/microorganisms13071461
Transmission of C. auris primarily occurs in healthcare settings through physical contact with contaminated surfaces or through person-to-person contact. Nosocomial transmission occurs via contaminated medical equipment, such as catheters or feeding tubes, and contributes to significant risk of infection among long-term patients in healthcare settings or intensive care units, and among people with serious underlying medical conditions.[2]
Detection of C. auris colonization may help reduce nosocomial transmission. The CDC recommends swabbing the axilla and groin and also identifies the nares (and hands) as collection sites having potential for improving the identification of colonized patients.[2] Processing and detection can involve either culture-based or real-time PCR (RT-PCR) methods. Culture-based methods are considered the gold standard because they allow for isolate recovery and susceptibility testing.[3] Culture-based methods also have 5- to 7-day turnaround times, which may be too long when rapid identification of C. auris is needed to implement public health measures to control the spread of infection.[4]
RT-PCR addresses some constraints of culture-based methods for detecting C. auris colonization. Species-specific RT-PCR can differentiate C. auris from other closely related species (e.g., Candida albicans, Candida glabrata) and in some cases can detect C. auris when culture does not.[5] Furthermore, RT-PCR can be performed much faster, with results generally available in 2 to 3 days.
The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.
References
1. Tracking Candida auris. Centers for Disease Control and Prevention. Updated March 3, 2026. Accessed April 14, 2026. https://www.cdc.gov/candida-auris/tracking-c-auris/
2. About Candida auris. Centers for Disease Control and Prevention. Updated February 26, 2026. Accessed April 14, 2026. https://www.cdc.gov/candida-auris/about/.
3. Detection and culture of fungi in clinical specimens. Blog. The Clinical and Laboratory Standards Institute. Updated January 13, 2021. Accessed April 14, 2026. https://clsi.org/resources/insights-blog/detection-and-culture-of-fungi-in-clinical-specimens/
4. Leach L, Zhu Y, Chaturvedi S. Development and validation of a real-time PCR assay for rapid detection of Candida auris from surveillance samples. J Clin Microbiol. 2018;56(2):e01223-01217. doi:10.1128/JCM.01223-17
5. Hsu C, Yassin M. Diagnostic approaches for Candida auris: a comprehensive review of screening, identification, and susceptibility testing. Microorganisms. 2025;13(7):1461. doi:10.3390/microorganisms13071461
Performing Laboratory
Quest Diagnostics
