When baby Emilia was in the neonatal intensive care unit last year, her parents never left her side. They roomed-in, held her for skin-to-skin cuddles, and breastfed whenever possible — practices now supported by the first-ever pediatric-specific guidance for preventing the spread of Candida auris, a dangerous drug-resistant fungus.
The Society for Healthcare Epidemiology of America (SHEA) has released a landmark consensus statement addressing a critical gap in infection prevention: until now, all recommendations for detecting and controlling C. auris focused exclusively on adults. The new guidance, published in Antimicrobial Stewardship & Healthcare Epidemiology, provides practical, setting-specific advice for protecting children from neonatal intensive care units to child care centers, schools, and family residential facilities.
Thomas Murray, MD, Ph.D., lead author of the statement, noted that because C. auris remains relatively rare in pediatric populations, clear communication and coordinated implementation are essential. The guidance gives clinicians and child-serving facilities a framework for practical decisions tailored to their unique environments.
What makes this guidance stand out is its embrace of family-centered care. Rather than treating caregiver involvement as a risk to be minimized, the recommendations explicitly support practices that research shows benefit children's development: rooming-in, breastfeeding, and skin-to-skin contact. When evidence is limited or patient-specific risks require individualized planning, the statement advocates for shared decision-making between families and care teams.
Lisa Maragakis, MD, MPH, president of SHEA, explained that children's care environments look very different from adult settings, and infection prevention guidance must account for the essential role of caregivers and families. The recommendations are designed to help teams reduce transmission risk while supporting family-centered pediatric care.
The guidance also tackles a sensitive issue: how to protect children from infection without unnecessarily excluding them from schools, child care, or other congregate settings. It encourages thoughtful disclosure practices that avoid stigma — recognizing that a child carrying C. auris should not be automatically barred from participating in normal childhood activities alongside appropriate precautions.
The consensus statement was developed by a multidisciplinary panel bringing together experts in pediatric infectious diseases, infection prevention, neonatology, early childhood education, long-term care, and family partnership. Their goal was to create guidance that protects vulnerable children while preserving the care practices that help them thrive.