427. Bloodstream infections among adult COVID-19 patients in Colombian hospitals between 2020-2021

BACKGROUND: Coronavirus is one of the major pathogens that primarily targets the human respiratory system. In COVID-19 patient’s, bloodstream infections (BSI) have not been extensively studied in Latin-America. Given the impact of COVID-19 pandemic in Colombia and the high rate of hospitalizations, information about risk factors and ways to prevent BSI among COVID-19 patients is urgently needed. This investigation aimed to identify risk factors in BSI in hospitalized patients with COVID-19. METHODS: A case-control design was used; cases were patients with a PCR confirmed COVID-19 infection and BSI. Controls were patients with a PCR confirmed COVID-19 who did not have a BSI during their hospitalization. Information about demographic, clinical characteristics, comorbidities and exposures that could be related to BSI were reviewed. Descriptive statistics were calculated, odds ratios (ORs) and 95% confidence intervals were estimated using multivariable conditional logistic regression models. In accordance with Colombian regulations -Resolution 8430 of the Ministry of Health of 1993- this project was classified as risk-free. RESULTS: 306 patients (153 cases and 153 controls) from four participating hospitals were included. Cases and controls had similar average age (62-63 years), median length of stay (19-25 days), comorbidities and similar Newscore scale regarding severity on admission to the hospital; all cases and 89% of controls required at least one invasive device. Cases were more likely to have required an orotracheal tube (97% vs. 81%; p< 0.05), central venous catheter (95% vs. 82%; p< 0.05), or urinary catheter (98% vs. 80%; p< 0.05) compared with controls. Cases had higher previous antimicrobials use (91% vs. 77%; p< 0.05), pronation (93% vs. 81%; p< 0.05) and chlorhexidine bath (58% vs. 83%, p< 0.05) than controls. However,no statistically significant differences in mortality between cases and controls was found. In the multivariate analysis, urinary catheter used (OR= 11.05; IC95% 1.18–103.18) was a risk factor and chlorhexidine bath (OR=0.47; IC95% 0.25–0.88) was a protective factor for BSI. CASE AND CONTROL CHARACTERISTICS [Figure: see text] BIVARIATE AND MULTIVARIATE ANALYSIS [Figure: see text] CONCLUSION: COVID-19 patients are more propense to BSI, but bathing with chlorhexidine and care and monitoring of invasive devices are modifiable factors to minimize the risk of infections. DISCLOSURES: Christian Pallares, MD, MSc, 3M: Advisor/Consultant|3M: Honoraria|MSD: Advisor/Consultant|MSD: Grant/Research Support|MSD: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Westquímica: Advisor/Consultant|Westquímica: Grant/Research Support|Westquímica: Honoraria María Virginia Villegas, n/a, MSD: Advisor/Consultant|MSD: Grant/Research Support|MSD: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|Westquímica: Advisor/Consultant|Westquímica: Grant/Research Support|Westquímica: Honoraria Karen Melissa Ordoñez, n/a, Pfizer: Advisor/Consultant|Pfizer: Honoraria