Clade-dependent resilience of Candidozyma auris challenges surrogate-based disinfectant testing: implications for efficacy testing of oxidative disinfectants

KM Mosel, A Maharani, J Mathew, M Meckel, A Belitz, FA Pitten, H Gabriel, FHH Brill, K Konrat, AM Richter, J Steinmann, A Lang, R Beck, B Hornei, A Dornaika, AD Wollkopf, S Engelhart, M Exner, C Ilschner, NT Mutters, J Gebel, M Rausch

Journal of Hospital Infection | Volume 176 | October 2026 | Pages 87-94 | DOI: 10.1016/j.jhin.2026.08.001

Background: Candidozymaauris has emerged as a globally relevant healthcare-associated pathogen characterized by environmental persistence, outbreak potential, and multi-drug resistance. Current yeasticidal disinfectant efficacy testing relies on Candidaalbicans as the standard surrogate organism. However, emerging evidence suggests that susceptibility may vary by clade, active substance, and formulation, questioning the universal adequacy of surrogate-based testing.

Aim: The aim of this study was to determine whether C. albicans adequately serves as a surrogate organism for yeasticidal disinfectant efficacy testing against C. auris, with particular focus on oxidative disinfectants, especially peracetic acid–based formulations.

Methods: A stepwise comparative design was applied. Standardized quantitative suspension testing assessed intrinsic susceptibility differences between C. albicans and C. auris using defined active substances. Subsequently, commercially available oxidative disinfectant products were evaluated under standardized application-relevant conditions. C. auris isolates representing different phylogenetic clades were included to assess clade-dependent susceptibility differences.

Findings: C. auris showed susceptibility comparable to or greater than that of C. albicans for alcohols, aldehydes, and quaternary ammonium compounds. In contrast, marked differences emerged for peracetic acid–based disinfectants. Several oxidative products demonstrated robust yeasticidal efficacy against all tested organisms, whereas selected peracetic acid–based products showed reduced efficacy against C. auris. The most pronounced differences were observed for clade I isolates.

Conclusion: Surrogate-based yeasticidal efficacy testing using C. albicans remains appropriate for most disinfectant product groups. However, for selected peracetic acid–based formulations, this approach may not universally provide a reliable assessment. Targeted inclusion of C. auris may therefore refine efficacy testing in selected scenarios.