282. Epidemiology of Candidemia in Patients with Solid Tumors of the Gastrointestinal Tract

Abstract

BackgroundThe Gastrointestinal (GI) tract is considered as an important source of candidemia. Numerous studies indicate that the majority of patients with candidemia and cancer have an underlying solid tumor mostly of the GI tract. Widespread use of antifungal prophylaxis among patients with selected hematological malignancies resulted in a proportional redistribution of the frequency of candidemia among patients with various malignancies, but the incidence of candidemia among patients with GI solid malignancies is unknown.MethodsA retrospective chart review of patients diagnosed with GI malignancies from 2010 to 2018 at Rochester Regional Health, Lipson Cancer Institute was conducted, and the incidence of candidemia was determined.ResultsA total of 2783 patients with GI malignancies were analyzed. Fifty-six percent were males, and a mean age was 67 years. Sites of malignancy included large intestine (n = 1269), pancreas (n = 394), any part of the mouth and associated organs (n = 282), liver and biliary system (n = 273), stomach (n = 235), esophagus (n = 135), small intestine (n = 110), and others (n = 85). Over the period of review, total mortality was 49%. Only 0.7% (n = 19) patients developed candidemia, with a total of 22 events. Nine episodes of candidemia happened prior to diagnosis of cancer, and 13 episodes developed after or at the time of diagnosis. There was no commonality in GI solid malignancy site among patients with candidemia. C. albicans was the most common isolate (9 episodes), followed by C. parapsilosis (8), C. glabrata (3), and C. dubliniensis (2). At the same time, there were 273 episodes of bacteremia in 230 patients (8%).ConclusionIn our study candidemia among patients with GI solid-organ malignancies was very rare.Disclosures All authors: No reported disclosures.