2887. Implication of genotypes for prognosis of Candida glabrata bloodstream infections

BACKGROUND: Genotyping a specific pathogen may demonstrate unique patterns of antimicrobial resistance and/or interaction between pathogen and host, which subsequently lead to miserable consequence. Herein, we conducted a retrospective single-center study to analyze the association between genotypes and clinical outcomes among Candida glabrata bloodstream infections (BSIs). METHODS: A standard case report form was used to collect the clinical data of hospitalized adults with C. glabrata BSIs in 2017. Antifungal susceptibility testing was performed by using the Sensititre YeastOne SYO-10 panel, and minimum inhibitory concentrations (MICs) were interpretated according to the Clinical and Laboratory Standard Institute. Genotyping was performed by using a multilocus sequence typing scheme, and further analyzed by the unweighted pair group method with arithmetic averages (UPGMA) method. RESULTS: Among 48 patients, clonal complex 7 (CC7, defined by UPGMA similarities >80%) was the most common CC (n=14, 29.2%). The rates of fluconazole and candin resistance were low (6.6% and 0%, respectively) without specific distributions among genotypes Charlson comorbidity index (adjusted odd ratio [aOR], 1.49; 95% CI, 1.05-3.11) was the only risk factor for CC7 C. glabrata BSIs. CC7 was independently associated with 28-day mortality (aOR, 5.88; 98% CI, 1.06-32.47) in addition to a APACHE II score of >18 (aOR, 5.84; 98% CI, 1.16-29.46). The Kaplan–Meier survival analysis also showed greater mortality in CC7 (Figure). Fluconazole resistance or candin therapy had no significant impact on mortality. [Figure: see text] CONCLUSION: Our data shed light on the impact of genotypes on clinical outcomes in C. glabrata BSIs. Further virulence characterization of CC7 is warranted. DISCLOSURES: All Authors: No reported disclosures