395. Impact of Racial Disparities on Clostridioides difficile Infection (CDI) Outcomes at a Southern California Academic Teaching Hospital

BACKGROUND: Infectious diseases are the second leading contributor to racial disparities in healthcare. Clostridioides difficile infection (CDI) is a common community/hospital acquired infection that can cause life-threatening colitis. Despite the influence that socioeconomic factors, insurance status, and access to care can have on CDI outcomes, there is a dearth of literature that evaluates the impact of racial differences. The objective of this study was to identify racial disparities in CDI and describe clinical outcomes among hospitalized adults. METHODS: This is an IRB approved, retrospective study of adult patients (≥ 18 years) hospitalized with initial episodes of CDI between January 2020 to June 2021. Initial CDI episodes were identified by the ICD-10 code A04.72. Medical records were reviewed for demographics, comorbid conditions, insurance, total length of stay (LOS), and need for intensive care unit (ICU) admission. Patients were dichotomized by race/ethnicity into either the racially and ethnically minoritized (REM) group or the non-Hispanic White (n-REM) group. P value of ≤ 0.05 was defined as significant. RESULTS: In total 220 patients (61.8% REM, 136/220; 38.2% n-REM, 84/220) with an initial CDI episode were included. Majority of the REM patients were Hispanic (38.2%) followed by Black (13.6%), and Asian (5%). Compared to the n-REM group, the REM patients were younger (60 vs 69 years, p =0.016) and were more likely to have underlying comorbidities (diabetes mellitus 33% vs 9.5%; p < 0.001 and chronic kidney disease 48.5% vs 21.3%; p < 0.001). The REM patients were more likely to present with fulminant CDI (21.3% vs 11.9%; p =0.1). The REM patients were also more likely to be admitted to the ICU during their stay (41.9% vs 26.2%; p =0.021) and have a longer hospital length of stay (LOS) (12 vs 7 days; p =0.02). Lastly, the REM patients were more likely to be under-insured with 91 patients (66.9%) having Medi-Cal insurance compared to 34 patients (40.5%) in the n-REM group (p < 0.001). CONCLUSION: Despite being younger, REM patients were more likely to require an ICU admission, have underlying comorbidities, have a longer LOS, and be under-insured. There is a need for further studies to understand disparities between REM and n-REM patients regarding CDI. DISCLOSURES: All Authors: No reported disclosures.