BackgroundCandida aurisis an emerging fungal pathogen that is often multidrug-resistant. It can persist on skin and in hospital environments, leading to outbreaks and severe infections for patients at risk. Several countries and institutions are working on establishing guidelines and recommendations for prevention. This review aims to assess the evidence on factors associated withC. auriscolonisation or infection, the duration of such colonisation, possible colonisation sites, and the risk of secondary transmission to inform screening recommendations. Methods We systematically searched five databases for primary studies and systematic reviews of our four outcomes. We excluded studies on treatment, management, laboratory methods, drug resistance, and environmental screening. From each paper, we extracted relevant data and summarised them in tables. Main findings were described narratively. Results We selected 117 studies for inclusion. Most of the studies were observational studies. The duration ofC. auriscolonisation varied, with up to and beyond a year being common. The predominant sites of colonisation were the axillae and groin, with the nares and rectum being less common sites. The risk of secondary infection saw considerable variation across the studies, and these secondary cases primarily involved patients and not health care workers. Critical care settings, invasive medical devices, recent antimicrobial use, and comorbidities were often associated withC. auriscolonisation and infection. Conclusion Our review highlights that, despite relevant findings on factors influencingC. auriscolonisation and infection, substantial gaps remain in the evidence supporting screening practices. Most studies were conducted reactively, in outbreak settings, and lack systematic protocols. Given these limitations, screening guidelines are likely to be more successful if grounded in medical theory and yeast microbiology rather than relying solely on current studies. Rigorous, well-designed research is urgently needed to inform futureC. aurisscreening and control efforts.
