P-1524. Clinical Characteristics and Outcomes of Patients with <i>Candida auris</i> at RUHS

Abstract Background Invasive Candidiasis Clinical Associations *: Immunocompromised status including patients on chemotherapy, status post organ transplant, HIV positive, etc. Methods We conducted a retrospective chart review of C. auris fungemia cases in adult hospitalized patients at RUHS between January 2022 to December 2023. Demographic data, clinical associations, antifungal susceptibility and clinical outcomes were noted using descriptive statistics. Antifungal Susceptibility Results Nine patients (n = 9) were identified. 8/9 (89%) presented from a long-term care facility. 5/9 (56%) patients were male gender averaging 65 years old (range 45-86yo). Charlson comorbidity index was 8.11. Clinical associations: invasive devices (9/9, 100%), long-term care residence (8/9, 89%), hospitalization within 90 days (7/9, 78%), IV antibiotic within 90 days (8/9, 89%), and surgery (5/9, 56%). All patients were treated with micafungin. Despite 100% susceptibility to echinocandins, fungemia duration was long (mean 242.1 hours; range 39.13-1431.75 hours) and 4/9 (44%) patients required a dose increase of micafungin (mean dose 194 mg; range 100-300 mg). Cases were further characterized by prolonged ICU length of stay (LOS (mean 15d, range 3-41d)), prolonged hospital LOS (mean 39.3d, range 9-65d), and high mortality (4/9, 44%). 2/5 (40%) survivors versus 0/4 (0%) deceased patients had source control. The majority of survivors 4/5 (80%) had a primary line-associated fungemia. 2/5 survivors (40%) were readmitted within 6 months. Mortality in Relation to Source Control Conclusion Patients from long-term care facility with additional clinical associations appear to have high risk for C. auris infection and complications. Consideration of higher initial dose echinocandins should be considered in management of patients presenting with C.auris fungemia. Aggressive source control of fungemia etiology should be pursued when possible. Disclosures All Authors: No reported disclosures