a riskCandida auris

A yeast that colonises skin, survives on surfaces for long periods, spreads between patients in healthcare facilities, and resists antifungal drugs. The CDC names it with carbapenem-resistant Enterobacterales as a pathogen that "appear[s] to be more common in some countries where U.S. residents travel for medical tourism".

What makes this organism a cross-border problem is that a carrier is not a patient. The CDC's own account is that people can have C. auris on their skin and elsewhere without symptoms, that they may not know, that colonisation persists on the body for a long time whether or not symptoms ever appear, and that a colonised person spreads it to surfaces and to other patients throughout. Screening is a skin swab, and it is performed only when somebody thinks to order it.

The drug position is narrow. Most strains resist at least one class of antifungal; echinocandins are the preferred treatment for most infections; some strains resist all three main classes, and for those the CDC notes limited data and the use of combinations or newer agents.

The CDC asks US facilities to report suspected or confirmed C. auris to public health authorities so that testing and infection control can be put in place before onward transmission.

Inference — the cost of this one falls almost entirely on the next hospital rather than on the patient who carried it. A colonised person who is otherwise well generates a side room, contact precautions, environmental decontamination and a screening round of everyone they shared a bay with. None of that appears on any bill connected to the operation abroad.

Risk concentrates in patients with severe underlying conditions and invasive devices — breathing tubes, feeding tubes, venous and urinary catheters — which is to say in intensive care and in long admissions rather than in a day-case dental chair. The CDC states that people without those risk factors generally neither carry it nor become ill from it, and that screening healthcare workers or family members is usually unnecessary. Attribution of death is explicitly uncertain: "When patients with C. auris die, it is hard to know how much C. auris contributed to their death compared to other pre-existing illnesses."

As of 16 September 2026 no destination publishes a colonisation rate for its hospitals, and no source market publishes a count of cases traceable to care received abroad. The CDC's travel-linked instruction is the six-month screening rule for carbapenem-resistant Enterobacterales; C. auris is reported when found, not screened for by travel history.