1697. Comparison of Candidemia in Patients in Neonatal Intensive Care Unit and Pediatric Patients and Big Data Analysis on Candidiasis and Candidemia in Korean Children

BACKGROUND: Fungal infection is a serious health threat in high-risk pediatric population. Data on pediatric epidemiology of candidemia in Korea are limited. METHODS: A retrospective chart review was performed in patients aged 0–18 years who were diagnosed with candidemia from 2009 to 2018 in a tertiary teaching hospital. Patients were divided into two groups; the neonatal group was comprised of babies with postnatal age 28 days or younger and any patients hospitalized in neonatal intensive care unit and rest of the patients were grouped into pediatric group. Only the first candidemia episode for each patient was included. In addition, the number of patients with candidemia and candidiasis and health cost was estimated among patients 19 years or younger who requested reimbursement to Health Insurance Review and Assessment Service (HIRA) Korea during the 9 year period from 2010 to 2018. RESULTS: Total 81 patients with candidemia were identified; 42 in the neonatal group and 39 in pediatric group. In neonatal group, prematurity was 95.2%, while hematology-oncology diseases were the most common underlying conditions in pediatric group. Among cultivated candida spp., C. parapsilosis was the most common pathogen (34.6%) followed by C. albicans (32.1%) and C. glabrata and C. tropicalis (11.1%, respectively). In neonatal group, C. parapsilosis (n = 17, 40.5%), C. albicans (n = 16, 38.1%), C. glabrata (n = 5, 11.9%) and unidentified species non-albicans candida (n = 4) were isolated. In pediatric group, C. parapsilosis (n = 11, 28.2%), C. albicans (n = 10, 25.6%), C. tropicalis (n = 9, 23.1%), C. glabrata (n = 4, 10.3%), C. krusei (n = 2), C. orthopsilosis (n = 1), C. lusitaniae (n = 1), C. kefyr (n = 1) were isolated. From HIRA data analysis, 47 patients were found to have candidemia and health cost was estimated as 1.27 million dollars and 66,286 patients were found to have candidiasis and health cost was 2.14 million dollars. CONCLUSION: Discrepancies in numbers for candidemia between national reimbursement data and our retrospective data implies a significant underestimation of candidemia. Increased awareness for fungal infection documentation is needed to better estimate the true burden of invasive candida infection in the pediatric population. DISCLOSURES: All authors: No reported disclosures.