Surface-associated Candida auris recovery during five intensive care unit cluster responses: a retrospective descriptive study with structured evidence mapping

Background Surface-associated persistence of Candida auris can complicate infection prevention in healthcare settings, particularly when reusable devices and mobile care items move across patient-care areas. During cluster responses, targeted environmental sampling may help identify surface and equipment categories for infection-prevention review. Methods We retrospectively reviewed environmental culture records collected during five C. auris cluster responses in the surgical and medical intensive care units of Sichuan Provincial People’s Hospital between August 2024 and May 2026. Patient, healthcare-worker, liquid, and product samples were excluded. Environmental site names were standardized using a 10-category functional framework based on item function, patient proximity, mobility or sharing, and cleaning responsibility. A secondary structured evidence-mapping search of PubMed, Web of Science Core Collection, Embase (Elsevier), and Scopus assessed whether locally identified surface and equipment categories had been reported in previous healthcare investigations. Results Among 177 environmental sampling records, 9 were culture-positive for C. auris (record-level culture yield, 5.1%). Positive records involved six standardized sites and five environmental categories. SpO 2 probes/clips accounted for four positive records and were the only standardized site type recovered in more than one cluster response. Other positive sites were a bed rail/bed unit, transfer board, chlorhexidine measuring cup, soiled-linen/textile cart, and hair-washing/bathing equipment. Each locally positive category was represented in the published evidence map. Conclusion C. auris was recovered from both fixed near-patient surfaces and reusable or mobile healthcare items, including monitoring accessories, transfer equipment, care-related items, and linen-handling equipment. These observations identify surface and equipment categories for consideration during infection-prevention review, particularly in relation to between-patient disinfection, drying, storage, equipment assignment, and separation of clean and used items. Because sampling was purposive and isolate relatedness was not assessed, these findings cannot be used to estimate environmental contamination prevalence, establish transmission, or evaluate intervention effectiveness.