P-1143. Implementing Admission Screening for Candida auris and Carbapanemase-Producing Organisms (CPOs) in a Low-Prevalence State

Abstract Background In response to CDC guidance recommending admission screening for Candida auris and carbapenemase-producing organisms (CPOs), the Oregon Health Authority (OHA) launched a statewide effort to encourage and support healthcare facilities in implementing screening protocols. Oregon remains a low-prevalence state for these organisms.Figure 1:Screen shot from Oregon’s interim admission screening guidanceWeblink: https://rebrand.ly/AdmissionScreeningFigure 2:Timeline of C. auris and CPO admission screening implementation in Oregon Methods Starting in 2022, OHA began outreach to all high acuity Oregon healthcare facilities: 63 acute care hospitals (ACHs), one long-term acute care hospital (LTACH), and one ventilator-capable skilled nursing facility (vSNF). Twenty-nine facilities were prioritized based on regional epidemiology and facility interest. Outreach included emails (14), response consultations (6), presentations (4), and a statewide webinar (1). Ten volunteer facilities helped develop Oregon-specific screening guidance, published April 2024 (figure 1). This guidance was shared during subsequent OHA-led infection prevention trainings and assessments.Figure 3:Percent of target healthcare facilities currently implementing routine admission screening (n=17) or actively working towards implementation (n=5) by geographic regionFigure 4:Monthly number of C. auris and CPO swabs collected over time**OHA relies on healthcare facility partners to voluntarily report the number of swabs collected and tested at labs other than OSPHL and ARLN. Positive results require mandatory reporting. Results An implementation timeline is shown in figure 2. As of 05/01/2025, 16 ACHs across six healthcare systems and one vSNF implemented routine admission screening; five additional ACHs are working toward it; and all other facilities are supported on an ad-hoc basis. At least one facility in each Oregon region is participating (figure 3). Screening criteria vary by facility or system. Facilities use a combination of labs to support testing including Oregon State Public Health Lab (7), Antibiotic Resistance Laboratory Network (5), private reference labs (4), and in-house clinical labs (1). When non-public health labs are used for screening, OHA relies on voluntary reporting of swab counts. Between 05/01/2023 and 03/31/2025, facilities collected 807 swabs; one of 543 C. auris swabs and four of 264 CPO swabs tested positive. Statewide screening has increased over time (figure 4). Conclusion Admission screening for C. auris and CPOs can identify cases that would otherwise remain undetected in low-prevalence regions. Challenges include resource allocation, training clinical and laboratory staff, turnaround time, and data sharing when non-public health labs are used. Oregon’s experience can guide other low-prevalence jurisdictions initiating admission screening. Disclosures Christopher D. Pfeiffer, MD, MHS, Department of Defense/MedPace: Grant/Research Support