1692. Epidemiology, Clinical Characteristics, and Outcomes of Candidemia in a Tertiary Hospital in the Dominican Republic

BACKGROUND: Candidemia is a major cause of morbidity and mortality in hospitalized patients. The global epidemiology of invasive Candidiasis is changing, with distribution of species and resistance varying in different geographic and healthcare settings. There is a paucity of data on candidemia in the Dominican Republic (DR). Understanding epidemiologic risk factors and resistance rates may improve early diagnosis and empiric antifungal selection. METHODS: We performed a retrospective review of patients with positive Candida blood cultures from January 2017 to December 2018. Data were extracted from medical records. Clinical and demographic information, including co-morbidities, antifungal sensitivities, and outcomes were collected. RESULTS: A total of 52 cases were identified, 34 in 2017 and 18 in 2018. Ages ranged from <1 to 89 years and was distributed in various groups (Figure 1). The most common comorbidities included DM (38%), nephropathy (37%), cerebrovascular accident (25%), and malignancy (19%). Device use and prior antimicrobial exposure were the most common risk factors (Table 1). There was no antifungal resistance to amphotericin, voriconazole, or echinocandins. No fluconazole resistance was found in 2017, compared with 11% resistance in 2018 in C. albicans, C. glabrata, and C. tropicalis species. Mortality was 64% in 2017 and 61% in 2018. CONCLUSION: Candidemia with non-albicans Candida species was common (87%). Susceptibilities and species varied by year but did not affect mortality. Resistance to fluconazole is rising but remains low and other antifungals retain susceptibility. Indwelling catheters, mechanical ventilation and antibiotic exposure were common risk factors in our cohort. Mortality for candidemia was high. Rapid diagnostic testing and early empiric therapy with echinocandins for patients at risk may curb mortality. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.