1163. Epidemiology of Candidemia: Can Candida Spread from Patient to Patient in the Hospital?

Abstract

BackgroundCandidemia has become an increasingly important infection in recent years. Antifungal drug resistance in non-albicans species of Candida is increasingly common. Recent global emergence of Candida auris is a concern, owing to person-to-person transmission and survival on fomites. Our study aimed to determine if hospital transmission of diverse Candida species is occurring similar to what is seen in Candida auris. We analyzed all candidemia infections for signatures of transmission, including species, geographical, and temporal clusters. Here we present our preliminary data from December 2019 - May 2020.MethodsThis is a prospective and retrospective analytical observational study. Patients with candidemia were identified with the help of the Clinical Microbiology Lab at a University Medical Center. Data was collected on all identified patients by retrospective chart review. Data was described in terms of frequency distributions and percentages, and analyzed using SPSS. Isolates have been stored prospectively as glycerol stocks at -80 C for ongoing analyses.Results37 patients were identified (Tables 1 and 2). Clusters of candidemia were seen in the months of January (C. parapsilosis, 3 patients), February (C.glabrata, 3 patients), March (C.albicans, 5 patients) and April (C.glabrata, 3 patients). 33/37 (89%) had a central line prior. Lines were removed in 73% (24/33) of these patients, the remaining patients were deceased before lines could be removed. Pancreatic pathology was seen in 15/37 (40.5%) patients (Table 3). 25/37 (67.5%) had an Ophthalmology consult.Table 1. Patient demographics Table 2. Epidemiology of candidemia Table 3. Pancreatic pathology in candidemia ConclusionIt is possible that the clusters identified shared equipment or other environmental factors that caused nosocomial transmission. We plan to use Whole Genome Sequencing to determine clonality among these isolates. The association of candidemia with pancreatic pathology was curious. It is to be evaluated whether this was simply a confounder or an actual risk factor that perhaps warrants consideration of prophylaxis. Rates of Ophthalmology consults to evaluate for endophthalmitis need to be improved in our setting. We hope that this study would prove valuable for infection control efforts and help us be better prepared to tackle emerging pathogens of this genus.Disclosures All Authors: No reported disclosures