181. COVID-19 Infection is a Key Factor in Mortality for Staphylococcus aureus and Candida sp. Bloodstream Infections: an Evaluation of Outcomes before and during the COVID-19 Pandemic

BACKGROUND: Staphylococcus aureus and Candida sp. bloodstream infections (BSI) are associated with considerable mortality. The COVID-19 pandemic presented new challenges in the acute care setting which may affect outcomes in high-risk populations. METHODS: Retrospective cross-sectional analysis across a large healthcare system of all admitted patients aged 18 years or older with S. aureus or Candida sp. BSI between pre-pandemic (January 2017-February 2020) and pandemic (March 2020- February 2023). The primary clinical outcome was all-cause mortality. Secondary outcomes include length of stay (LOS) and 30-day readmission. Data was stratified across the pre-pandemic and pandemic period, COVID-19 positive and negative patients, and community and hospital-onset BSI. RESULTS: A total of 17,730 patients were included in the analysis. Baseline characteristics were similar between pre-pandemic and pandemic groups aside from higher hospital-onset infection rates in the pandemic COVID-19 positive population [Table 1]. No significant differences were found in mortality between COVID-19 negative groups [Table 2]. Concomitant COVID-19 infection was associated with increased mortality in both the S. aureus and Candida sp. BSI patients. [Figure: see text] [Figure: see text] CONCLUSION: While patients with concomitant COVID-19 infection had a substantially higher mortality compared to those without infection, the mortality in patients with S. aureus and Candida sp. community-onset and hospital-onset BSI did not change during the pandemic compared to pre-pandemic for patients without concomitant COVID-19 infection. DISCLOSURES: Reese Cosimi, PharmD, Allergen: Advisor/Consultant