1341. Risk Factors for Candidemia after Cardiac Surgery in Pediatric Patients with Congenital Heart Defects

Abstract Background Candidemia is a serious complication in children with congenital heart defects (CHD) after cardiac surgery. Data on risk factors for postoperative candidemia this high-risk population remains limited. This study aimed to identify the incidence, outcome, and population. Methods retrospective case-control was carried out at two different pediatric intensive care units between 2004-2019. cases were matched control patients without candidemia. Univariate multivariable logistic regression analyses conducted Results Overall, 105 included. Thirty-five 70 cases. The overall incidence of 6.3/1000 admissions. median age 4 months (range 16 days 9.4 years). Crude 30-day mortality 43%. Risk independently associated included cumulative antibiotic exposure ≥4 (OR 4.3, 95% CI 1.3-14.6; p =0.02), need total parenteral nutrition (TPN) or peritoneal dialysis 6.1, 2-18.8; =0.001), male gender 6.2, 1.8-21.6, p=0.04) delayed sternal closure ≥ 2 3.2, 1-11.2; =0.05). areas under receiver operating characteristic curves days, TPN dialysis, gender, overall, 0.74 (95% CI, 0.64-0.84), 0.75 0.65-0.85), 0.65 0.53-0.77), 0.55-0.77) 0.87 0.81-0.94) respectively, which an excellent discrimination. Receiver Operating (ROC) Conclusion We found that CHD uncommon complication, occurring mostly young infants. In our population, strongest independent discriminative factors. However, adding previously unreported risks such as strengthen Our results may help define should be given prophylactic presumptive antifungal therapy. Disclosures All Authors: No reported disclosures.