1454. Descriptive Epidemiology of Candida auris Infections in African-American population in Tertiary Care Center in Greater Detroit Area

Abstract

Abstract Background The first reported Candida auris (C. auris) cases in United States, were associated with global travel. It has emerged as a nosocomial pathogen among critically ill patients with prolong hospital stay, patients in long-term-acute hospitals, and skilled nursing facilities. Given the increase in cases (59% in 2019 to 95% in 2021) and C. auris being multidrug-resistant, Centers for Disease Control and Prevention has declared it to be a pathogen of urgent public health threat. The purpose of this study is to describe the epidemiology of C. auris among patients in a tertiary care center in greater Detroit area. Methods A retrospective cohort study was conducted among patients who tested positive for C. auris between January 2021 to January 2023. See Figure 1 flow chart of screening and culture method used to identify C. auris. Patients were defined as infected or colonized based on review of medical documentation. Data on demographics, length of stay, source of admission, treatment and susceptibility report were collected. Results One hundred and eight patients tested positive for C. Auris with 10 infections and 98 colonizations. 90% of infected patients were in intensive care unit, 80% required a ventilator, 50% had fungemia and 40% died within 30 days of C. auris infection (Table1). Among the 4 patient that died, median age was 67.5, one patient had persistent C. auris fungemia due to endocarditis, one patient had decompensated cirrhosis with concomitant bacteremia and urinary tract infection with C. auris, one patient had C. auris mediastinitis with severe cardiac comorbidities, and one patient had abdominal aortic aneurysm repair developed ventilator associated pneumonia with C. auris and Aspergillus Niger complicated by severe acute respiratory distress syndrome. 80% of patients were treated with micafungin and one patient was treated with micafungin and amphotericin B given C. auris endocarditis (Table 1). Voriconazole was used for treatment in one patient due to concomitant Aspergillus infection (Table 1). See Table 2 for minimum inhibitory concentration for 8 of 10 isolates. Conclusion C. auris is an emerging pathogen that can colonize the skin and has a potential of causing invasive infections leading to high morbidity and mortality. Disclosures All Authors: No reported disclosures