1702. Prevalence and Risk Factors for Endogenous Fungal Endophthalmitis in Adult Patients with Candidemia at a Tertiary Care Hospital in South Korea Over 13 years

Abstract Background Endogenous fungal endophthalmitis is one of the critical complications of candidemia in adult patients. We conducted a study to investigate the prevalence and risk factors for endogenous fungal endophthalmitis in adult patients with candidemia. Methods Adult patients ≥19 years with candidemia who underwent ophthalmological examination after the diagnosis of candidemia at a tertiary care hospital in South Korea from 2006 to 2018 were enrolled, and clinical data were collected. Results There was a total of 152 adult patients with candidemia who underwent an ophthalmological examination. Endogenous fungal endophthalmitis was found in 29 patients (19.1%). Patients were categorized into two groups (Non-endophthalmitis [NE] and endophthalmitis [E]). Between two groups, there was no significant difference in terms of age, sex, underlying comorbidities. Also, no difference in clinical conditions at the diagnosis of candidemia was noted including concomitant bacteremia, presence of septic shock, receipt of recent surgery, presence of neutropenia, total parenteral nutrition, central venous catheter, urinary catheter, ventilator, dialysis, use of antibiotics, and Candida spp. colonization. However, there was a higher rate of abnormal alanine aminotransferase (ALT) in the E (35.7%) than in the NE (14.8%), P = 0.008. Moreover, the proportion of C. albicans candidemia was higher in the E (65.5%) than in the NE (35.8%), P = 0.003. In contrast, C. parapsilosis candidemia was more common in the NE (27.6%) than in the E (6.9%), P = 0.018. Although there was a trend of higher mortality rate in the E (51.7%) than in the NE (35.0%), no statistical significance was observed, P = 0.095. Multivariate logistic analysis showed C. albicans candidemia (odds ratio [OR] 4.122, 95% confidence interval [CI] 1.653–10.280, P = 0.002) and abnormal ALT (OR 3.839, 95% CI 1.427–10.333, P = 0.008) were significantly associated with E cases. Conclusion Endogenous fungal endophthalmitis occurred in 19% of adult patients with candidemia. C. albicans candidemia and abnormal ALT were significantly associated with endophthalmitis. Adult patients with candidemia caused by C. albicans or having abnormal ALT need to be closely monitored for the possibility of endophthalmitis. Disclosures All authors: No reported disclosures.