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WhatAU : Pleaseconfirmthatallheadinglevelsarerepresentedcorrectly: is Candida auris skin colonization? The recently emergent fungal pathogen Candida auris frequently persists on skin of patients and can cause invasive disease with mortality rates over 50% [1,2]. It is the first fungal pathogen to be labeled as an urgent global public health threat due to its high capacity for person-toperson spread and its ability to produce recalcitrant, drug-resistant infection [1–5]. Since identification in 2009, C. auris has rapidly spread around the world, now accounting for 20% to 30% of Candida bloodstream infections in some healthcare settings [6,7]. Prior to development of invasive disease, C. auris colonizes patients, proliferating on the skin and at other nonsterile sites [4,6]. Of patients colonized with C. auris, approximately 95% involve the skin [8]. In a study of critically ill patients admitted to an intensive care unit, C. auris bloodstream infection developed in approximately 25% of patients within 60 days following skin colonization [8]. This pathogenicity pattern distinguishes C. auris from other Candida species, including Candida albicans, which typically reside as commensals in the gastrointestinal tract prior to the development of disseminated disease. C. auris frequently colonizes the axilla and groin, sites typically sampled in the screening of patients for resistant bacteria, including methicillin-resistant Staphylococcus aureus [9–11]. However, a broader investigation of residents in a skilled nursing facility identified C. auris colonization across 10 different body sites, with frequent colonization of 2 or more areas [12]. While the investigators similarly detected C. auris from axilla and groin samples, other colonization sites included the nares, fingertips, palms, toe webs, and perianal skin. C. auris appears to persist at a variety of patient skin sites for many months. With a breach of the skin barrier, C. auris can enter the bloodstream and produce invasive disease. Such breaches commonly occur in hospitalized patients who routinely undergo vascular catheter placement, gastrostomy tube insertion, and/or other surgical procedures, all of which correlate with invasive C. auris infection [4,13]. In addition, the skin of colonized patients (intact or desquamated) regularly contacts shared medical equipment and other surfaces, which appear to contribute to continued nosocomial transmission [2,4,14].