P244 Catheter-associated blood stream infections due to Wickerhamiella pararugosa in a patient with acute myeloid leukemia: Review of lit eratures

POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: OBJECTIVES: This report aims to present a case of Candida pararugosa bloodstream infection, review previous cases with C. pararugosa infections, and provide a concise review of the clinical background, risk factors, and brief the management of infections. METHODS: A 3-year-old boy with a history of acute myeloid leukemia was hospitalized in Omid Hospital, Isfahan, Iran. Two consecutive blood cultures were taken from the peripheral vein and port catheter; after that empirically meropenem was administered. RESULTS: Candida pararugosa were isolated from blood based on conventional and molecular assays. Furthermore, the antifungal susceptibility profiles of the isolate were determined, which exhibited resistance to fluconazole (8 μg/ml). Antifungal therapy with caspofungin and removing the patient's port led to a significant clinical improvement of the patient's conditions. So far, in the literature review, 10 cases of clinical C. pararugosa isolates were found, of which 5 points had bloodstream infections. CONCLUSION: Infections caused by uncommon Candida species have dramatically increased in recent decades, mostly among hematological malignancies. Most patients with C. pararugosa infection presented with specific underlying conditions, such as malignancy, sarcoma, surgery, and adult acute myeloid leukemia. Patients with indwelling catheters run a high risk of acquiring C. pararugosa bloodstream infection. Therefore, special consideration should be given to opportunistic fungal infections in immunocompromised individuals using catheters.