P-346. <i>Candida auris:</i> Colonization, Risk Factors and Antifungal Susceptibility at a Tertiary Healthcare Setting

Abstract Background Candida auris, a multidrug-resistant nosocomial pathogen, has emerged globally as a major threat to healthcare settings, and several hospital outbreaks continue to be reported. We attempted to study the risk factors associated with C. auris colonization and its antifungal susceptibility at a tertiary healthcare center. 1.Distribution of Candida auris isolates Methods A prospective observational study was conducted over 18 months. Patients were screened for Candida auris colonization by axillary, groin swabs, and urine cultures within 48 hours of admission. Patients with extended hospital stays, exhibiting clinical isolates positive for C. auris, were also included. Baseline characteristics and risk factors were assessed. In patients with positive C. auris isolates, samples from inanimate surfaces, hands of healthcare workers and patient care attendants were also screened for C. auris colonization. Antifungal susceptibility testing was done for all isolates. Results Ninety-nine patients (59% males) were included with a mean age of 43.1±18.06 years. There were 34 Candida auris isolates from 20 patients. Sixteen patients (80%) were colonized, and four (20%) had candidemia. Median duration of urinary catheterization (9 vs 3 days [p=0.01]) and prior antifungal exposure(p=0.04) were significant risk factors for C.auris colonization. Seventy-eight samples from bed rails, monitors, healthcare workers, and patient-care attendants showed no growth of C.auris. Antifungal susceptibility testing showed 87.5% and 37.5% of isolates were resistant to Fluconazole and Amphotericin B respectively, while all isolates were susceptible to Micafungin and Caspofungin. Conclusion Prior outbreaks of Candida auris at our medical ICU prompted the need for early identification, effective contact precautions, and decolonization to prevent fatal invasive infections. Patients with long-term urinary catheters in situ, prior exposure to antifungals, and prolonged hospital stay were found to be at risk for C.auris colonization, warranting further studies to implement routine screening in these high-risk groups. Disclosures All Authors: No reported disclosures