P357 Update on risk factors for Candida krusei-Fungemia

Abstract Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Institut für Medizinische Mikrobiologie der Universitätsmedizin Essen, Robert Koch Haus, Virchow Straße 179, 45147 Essen, Germany Objectives Infection with Candida species have been an increasing threat to hospital patients worldwide. During the last decade research has shown high mortality rates associated with candidemia and progressing drug resistance to NAC (non-albicans Candida) species. This study aims to solidify risk factors for C. krusei fungemia. Patients and Methods: We retrospectively analyzed patient data with at least one C. krusei or C. albicans positive blood culture at Essen University Hospital between 2008–2020. Relevant categories consisted of age, gender, underlying condition, central venous catheters (CVC), steroids, leukopenia <4000/μl, diabetes, antifungal treatment, hospital ward, and outcome. We used the Chi-Squared test to compare categorical valuables. P-values were considered significant <.05 and highly significant <.01. Results From 1380 patients who tested positive for Candida spp. between 2008–2020, 40 were positive for C. krusei and 786 for C. albicans. Candida albicans presented as the leading species (57.0%), followed by C. glabrata (23.5%), C. parapsilosis (5.8%), C. tropicals (5.1%), and C. krusei (2.9%). A total of 67.6% of patients were located at ICU. Incidence rates for Candida positive blood cultures increased from 1.0% to 10.0%. Candida krusei was most common in patients 51–60 years of age. In both groups, overall survival was identical (52.2% C. krusei/54.3% C. albicans). For C. krusei correlation between outcome and antifungal treatment was highly significant (P .044). A total of 20% more C. krusei infected hemato-oncology patients died than in the C. albicans group (62.5% C. krusei/46.5% C. albicans). In all, 60.0% of C. krusei patients on ICU died. In the C. krusei group all patients with CVC died and all patients without survived. Conclusion Candida-positive blood cultures increased from 1% in 2008 to 10% in 2020. Three major risk factors for C. krusei fungemia were found: CVC, hemato-oncology malignancies, and leukocytopenia.