P-246. <i>Candida auris</i> Central Line Associated Blood Stream Infection Trends in Chicago Acute Care Hospitals, 2018-2023

Abstract Background The emergence of antifungal resistance and propensity of Candida auris to cause healthcare facility outbreaks and severe outcomes in patients has deemed it a target pathogen for public health mitigation efforts. Data sharing between the Chicago Department of Public Health (CDPH) and the National Healthcare Safety Network (NHSN) allows for the surveillance of central line associated blood stream infections (CLABSIs) in Chicago healthcare facilities. We reviewed the Candida species associated with CLABSIs to assess C. auris contribution to CLABSIs in Chicago over time. Methods Data was reported by 32 acute care hospitals (ACHs), including five long- term ACHs between July 1, 2018 and June 30, 2023. All but one ACH provided data for the entire reporting period. We examined trends of central line associated candidemia over time, specifically C. auris. A Fischer's exact test was calculated to determine if the proportion of C. auris significantly differed from 2019 to 2022. Patient demographics and outcomes were summarized for individuals with Candida species grown on culture. Results From July 1, 2018-June 30, 2023, 2,362 CLABSIs were reported of which 460 (19.5%) were associated with Candida species. The median age of patients with Candida CLABSIs was 60 years (IQR: 45-69 years), and over half (58.7%) of individuals were male. Among 160 patients who had a Candida associated CLABSI and cause of death data available, candidemia contributed to 18.8% of deaths. The contribution of C. auris to candidemia CLABSIs increased from 10.3% in 2019 to 19.4% in 2022 (p=.1353) and C. parapsilosis increased from 13.2% to 19.4%, while C. albicans declined from 32.4% to 24.3%, respectively (Table 1). Conclusion Candida species make up close to 20% of CLABSIs reported by Chicago ACHs during 2018-2023, with C. auris contributing to nearly one-fifth of them in 2022. While the growing proportion of CLABSIs associated with C. auris from 2019 to 2022 is not statistically significant, it has clinical significance, and demonstrates that healthcare facilities should emphasize critical assessment of need for central line placement and infection control interventions, such as hand hygiene and environmental cleaning, to prevent further spread of C. auris. Disclosures All Authors: No reported disclosures