2450. Clinical Outcomes of Candida auris Infections at an Academic Medical Center

BACKGROUND: C. auris (CA) is a globally emerging fungus with a high case fatality rate (CFR). Cases of CA infection have been reported around US with a concentration in large metropolitan areas, but there is still little of data evaluating the prevalence and outcomes associated with CA. The purpose of this study was to evaluate the characteristics and outcomes in patients (pts) with CA isolation at a large urban academic medical center. METHODS: This was a retrospective, observational cohort study of hospitalized pts with a positive culture with CA between Oct 2020 and Dec 2021 via VITEK MS. We included pts ≥18 years of age and excluded those with only a positive surveillance screen from axillary swab. Demographic and clinical data at the time of CA isolation and up to 30 days or hospital discharge were collected from the electronic medical record. The primary outcome was 30-day CFR in patients with a culture positive for CA. RESULTS: We identified 37 patients, and 27 met inclusion. Of all included patients, 17 (63%) presented from acute or subacute long-term care facilities. 11 (40.7%) had CA isolated from a blood culture. 8/11 (72.7%) bloodstream infections were catheter-associated. Pts with fungemia had a median [IQR] length of antifungal treatment of 20 [6.5, 49.5] days, and all received micafungin. The median [IQR] days between index blood culture and first negative blood culture was 4 [3, 6.25]. 1 patient with fungemia never cleared repeat cultures despite treatment. Of all included pts, 7 of 27 (25.9%) expired within 30 days of CA isolation. The 30-day case fatality was 45.5% (5/11) in those with fungemia and 12.5% (2/16) in those with isolation from other sites. CONCLUSION: In our study, we report a similar institutional CFR of CA infections compared to the crude CFR within the U.S. We also report a higher CFR associated with CA fungemia compared to patients without positive blood cultures. These findings should be validated with a larger study population. DISCLOSURES: Larry H. Danziger, PharmD, Ferring Pharmacetuicals: Advisor/Consultant Rodrigo M. Burgos, PharmD, MPH, Janssen Therapeutics & Vaccines: Grant/Research Support|Merck & Co., Inc.: Grant/Research Support|ViiV Healthcare: Advisor/Consultant