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Background: Environmental contamination is suspected to play an important role in Candida auris transmission. Understanding speed and risks of contamination after room disinfection could inform environmental cleaning recommendations., Methods: We conducted a prospective multicenter study of environmental contamination associated with C. auris colonization at 6 ventilator-capable skilled nursing facilities and 1 acute care hospital in Illinois and California. Known C. auris carriers were sampled at 5 body sites followed by sampling of nearby room surfaces before disinfection and at 0, 4, 8, and 12 hours after disinfection. Samples were cultured for C. auris and bacterial multidrug-resistant organisms (MDROs). Odds of surface contamination after disinfection were analyzed using multilevel generalized estimating equations., Results: Among 41 known C. auris carriers, colonization was detected most frequently on palms/fingertips (76%) and nares (71%). C. auris contamination was detected on 32.2% (66/205) of room surfaces before disinfection and 20.5% (39/190) of room surfaces by 4 hours after disinfection. A higher number of C. auris-colonized body sites was associated with higher odds of environmental contamination at every time point following disinfection, adjusting for facility of residence. In the rooms of 38 (93%) C. auris carriers co-colonized with a bacterial MDRO, 2%-24% of surfaces were additionally contaminated with the same MDRO by 4 hours after disinfection., Conclusions: C. auris can contaminate the healthcare environment rapidly after disinfection, highlighting the challenges associated with environmental disinfection. Future research should investigate long-acting disinfectants, antimicrobial surfaces, and more effective patient skin antisepsis to reduce the environmental reservoir of C. auris and bacterial MDROs in healthcare settings., Competing Interests: Potential conflicts of interest. G. M. G., R. D. S., R. S., R. P., S. S. H., and M. K. H. have the following disclosures: Conducted studies where participating healthcare facilities received contributed antiseptic and cleaning products from Medline Industries, Inc., and Xttrium Laboratories. Companies had no role in the design, conduct, or analysis of these studies. The remaining authors have no conflicts to declare. K. B. reports other financial or nonfinancial interests: Conducted studies where participating hospitals/nursing homes received cleaning and antiseptic product from Medline Industries (payment to institution). G. M. G. also reports the following grants or contracts to institution: NIAID 5F31AI172386-02: Endemic and Emerging Multidrug Resistant Organisms in Nursing Homes: A Neglected Clinical Setting and 1P01AI172725: MDRO Carriage, Transmission, Sequelae, and Prevention in Nursing Homes. M. K. H. reports a position as unpaid volunteer position as President SHEA Board of Trustees and the following grants or contracts to institution: CDC BAA 75D301-19-67835 Evaluating emergence of resistance and changes in clinical pathogens following introduction of chlorhexidine bathing. S. S. H., R. S., J. S., and R. D. S. report grants or contracts to institution: 1P01AI172725: MDRO Carriage, Transmission, Sequelae, and Prevention in Nursing Homes. S. E. S. reports the following grants or contracts to institution: NIH—1R01AI175227-01 (Subaward from University of Michigan) and Cohn Fellowship Intramural Career Development Grant (Rush University Medical Center); travel stipend to cover travel costs to present at IDWeek 2022 from Society for Healthcare Epidemiology of America. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)