P084 Trichosporon osis awakening: molecular and antifungal susceptibility study on Trichosporonosis in North India and how antifungal stewardship can contribute in control

POSTER SESSION 1, SEPTEMBER 21, 2022, 12:30 PM - 1:30 PM: BACKGROUND: Trichosporon spp are yeast-like organisms belonging to class Basidiomycetes which are usually commensals. It can cause diseases ranging from superficial infection, commonly known as White Piedra, to disseminated infections (Trichosporonosis). Cases of invasive Trichosporonosis have increased worldwide. It has now become the second most common cause of fungemia after Candida spp, especially in immunocompromised individuals. METHODS: We conducted a hospital-based prospective chart review of six patients with nosocomial infections caused by Trichosporon spp. Demographic data, clinical history, comorbidities, and outcomes after treatment were collected. Samples were processed using conventional media, biochemicals, and confirmed using automated system, MALDI-TOF and VITEK-2 RESULTS: A total of 8 patients developed UTIs and 4 developed disseminated bloodstream infections. All patients had associated co-morbidities. All patients had history of treatment with antimicrobials which were ineffective. In all, 8 patients were identified to be infected with T. asahii and 4 with T. mucoides. All patients showed improvement with azoles. We also encountered a case of breakthrough Trichosporonosis. CONCLUSION: Invasive Trichosporonosis developed in patients with associated risk factors. Trichosporon spp presents diagnostic and therapeutic challenges. It is usually confused with disseminated candidiasis leading to incorrect treatment and increased risk of breakthrough Trichosporonosis. Prolonged undiagnosed infection can lead to disseminated infection. New triazoles have shown to be effective against Trichosporon spp.