P-2144. <i>Candida auris</i> skin colonization and the risk of subsequent <i>C. auris</i> bloodstream infection in two teaching hospitals

Abstract Background Candida auris, an emerging yeast that can cause outbreaks of severe infections in healthcare facilities, has shown an increased spread since the start of the COVID-19 pandemic. This study aimed to investigate the relative risk of subsequent C. auris bloodstream infection (BSI) in patients colonized on their skin by C. auris. Methods In this retrospective study, we included all inpatients hospitalized from January 2021 to December 2023, in Intensive Care Units (ICUs) or internal medicine wards of two distant teaching hospitals (Athens: Attikon University Hospital, Thessaloniki: AHEPA University Hospital), who were screened for skin colonization by C. auris and did not have a history of infection or colonisation by C. auris. The axilla and groin served as sampling sites. Screening was performed by selective media and species identification by MALDI-TOF. Patients were followed up for C. auris BSI and relative risk (95% confidence interval) was estimated after adjustment for ICU hospitalization, duration of hospitalization, age and sex. Results Of 1445 patients screened, 403 (27.9%) were colonized by C. auris (17.8% non-ICU, 82.2% ICU patients). Among them, 45 (3.1%) subsequently developed C. auris BSI. Skin C. auris colonization was associated with more than a 4-fold higher risk of subsequent C. auris BSI, after adjusted for ICU hospitalization, age, sex and duration of hospital stay [RR (95%CI): 4.27 (2.13-8.57)]. Conclusion C. auris skin colonization increases significantly the risk of developing C. auris BSI. This underscores the significance of public health monitoring and containment strategies for C. auris. Adhering to infection control protocols is crucial, and healthcare providers should take this into account when deciding on initial treatment, although more comprehensive genome-wide data are necessary to confirm horizontal transmission. Disclosures All Authors: No reported disclosures