254. National Trends in the Japanese Distribution of Major Candida Species Causing Candidemia During 2003–2017: A Report by the Epidemiological Investigation Committee for Human Mycoses in Japan

BACKGROUND: Candida species are a common cause of nosocomial bloodstream infections, and candidemia is associated with high mortality rates among adults and neonates. There is limited epidemiological data regarding candidemia in Japan. Therefore, the Epidemiological Investigation Committee for Human Mycoses in Japan performed a retrospective epidemiological survey of candidemia and causative Candida species. METHODS: Blood culture results from 2003 to 2017 were retrospectively evaluated. The data included the center-specific numbers of annual blood cultures, bacterial isolates that included fungi, numbers of fungi, and Candida species. Data were collected from 10 Japanese university hospitals located on all over Japan. RESULTS: A total of 433,961 blood cultures were included. The prevalence of fungi in all cultures and in positive cultures were 0.53 ± 0.07% and 3.78 ± 0.47%, respectively. Among the results that were positive for Candida species (N = 2,270), C. albicans was the most common species (39.2%) and was followed by C. parapsilosis (22.8%), C. glabrata (15.6%), C. tropicalis (9.7%), C. krusei (2.2%), and others. And the temporal changes in the five major Candida species’ distributions were analyzed. The frequency of C. albicans was 48% in 2003 and 2004, approximately 40% during 2005–2011, approximately 30% in 2012 and 2014, and 40% in 2015–2017. The next most common species were C. parapsilosis and C. glabrata. The frequency of C. parapsilosis was approximately 16% in 2003, approximately 28% during 2005–2009 and 21.7% during 2010–2017. There was a significant difference in the C. parapsilosis rates for the first and second halves of the study period (24.8% vs. 21.7%, P = 0.03). The frequency of C. glabrata was <10% during 2004–2006, and approximately 17% after 2010. C. glabrata was significantly more common in the second half of the study period, compared with in the first half (12.0% vs. 17.3%, P = 0.004). The frequency of C. tropicalis remains stable, and C. krusei was significantly less common in the second half of the study period, compared with in the first half (4.3% vs. 1.6%, P <0.001). CONCLUSION: The frequency of C. albicans has varied in each year in Japan, while that of C. glabrata has increased. Additional surveys are needed to continuously monitor the trends in the distribution of candidemia in Japan. DISCLOSURES: All authors: No reported disclosures.