218. A 5-Year Retrospective Study of Actinomyces Odontolyticus Bacteraemia

Abstract Background Actinomyces species are Gram positive anaerobic, non-sporulating, non-acid fast, non-motile, irregularly staining bacterium. It is associated with a wide range of infections including; dental caries, abscesses, intraabdominal and bloodstream infections. A. odontolyticus normally a commensal organism found in the mouth, was first isolated from dental caries in 1958. The incidence of Actinomyces odontolyticus bacteremia is less common. Methods We are reporting 15 cases of isolated A. odontolyticus blood stream infection at HMC, State of Qatar from 1/1/2016 to 1/11/2020. We aim to describe their clinical characteristic, risk factors and treatment outcome. Results Our patients with bacteraemia fall into one of two groups. The first group consists of paediatric patients with unremarkable co-morbidities. The second group includes older adults, often with co-morbidities that pre-dispose to infection, such as diabetes mellitus or hypertension. Fever was the main presenting sign and symptom in 12 patients (80%). Nine of the patients were females (60%). 13 patients (86%) received antibiotics. Maximum duration of antibiotics was 60 days and minimum duration was three days. The infectious disease team was consulted for six patients (40%). One patient died while the other 14 recovered uneventfully with a case fatality rate of 6.6%. Reported cases of Actinomyces odontolyticus bacteraemia in Hamad Medical Corporation between 1/1/2016 to 1/11/2020 Minimal inhibitory concentrations (MICs) of selected antibiotics against A. odontolyticus, including interpretations and breakpoints, as reported by the AMRHAI reference unit, PHE Colindale Conclusion Clinicians of all specialties need to be aware of the rising number of reports of Actinomyces species bacteraemia due to widespread availability of molecular identification techniques, including MALTI-TOF. 3 Furthermore, more studies are needed to determine guidelines for treating these resilient microbes Disclosures All Authors: No reported disclosures


A 5-Year Retrospective Study of Actinomyces Odontolyticus Bacteraemia
Background. Actinomyces species are Gram positive anaerobic, non-sporulating, non-acid fast, non-motile, irregularly staining bacterium. It is associated with a wide range of infections including; dental caries, abscesses, intraabdominal and bloodstream infections. A. odontolyticus normally a commensal organism found in the mouth, was first isolated from dental caries in 1958. The incidence of Actinomyces odontolyticus bacteremia is less common.
Methods. We are reporting 15 cases of isolated A. odontolyticus blood stream infection at HMC, State of Qatar from 1/1/2016 to 1/11/2020. We aim to describe their clinical characteristic, risk factors and treatment outcome.
Results. Our patients with bacteraemia fall into one of two groups. The first group consists of paediatric patients with unremarkable co-morbidities. The second group includes older adults, often with co-morbidities that pre-dispose to infection, such as diabetes mellitus or hypertension. Fever was the main presenting sign and symptom in 12 patients (80%). Nine of the patients were females (60%). 13 patients (86%) received antibiotics. Maximum duration of antibiotics was 60 days and minimum duration was three days. The infectious disease team was consulted for six patients (40%). One patient died while the other 14 recovered uneventfully with a case fatality rate of 6.6%.
Reported cases of Actinomyces odontolyticus bacteraemia in Hamad Medical Corporation between 1/1/2016 to 1/11/2020 Minimal inhibitory concentrations (MICs) of selected antibiotics against A. odontolyticus, including interpretations and breakpoints, as reported by the AMRHAI reference unit, PHE Colindale

Conclusion.
Clinicians of all specialties need to be aware of the rising number of reports of Actinomyces species bacteraemia due to widespread availability of molecular identification techniques, including MALTI-TOF. 3 Furthermore, more studies are needed to determine guidelines for treating these resilient microbes Disclosures. All Authors: No reported disclosures
Methods. This retrospective cohort study conducted between December 2016 and December 2020 included adults with UGN BSI administered oral step-down therapy for at least 1/3 rd the total antibiotic duration. The primary outcome was incidence of treatment failure of HIGH-BIO compared to LOW-BIO agents within 90 days of completing oral therapy. Treatment failure was a composite of all-cause mortality, recurrent BSI, reinfection of the primary site, or transition to IV antibiotics after initiating oral therapy. Secondary outcomes were incidence of treatment failure of HIGH-BIO compared to HD-BL agents, and of HD-BL compared to LD-BL agents. Results

Conclusion.
No difference in treatment failure was observed between groups; further study is needed due to failure to reach statistical power. A numerical trend towards increased recurrence of BSI was observed with LOW-BIO agents. Betalactams may be reasonable for step-down therapy of UGN BSI if HIGH-BIO agents are contraindicated. Background. Background: Extracorporeal membrane oxygenation (ECMO) is a growing modality of life support that is subject to a high rate of nosocomial infections. There is a paucity of data to guide treatment for infections on ECMO, which can lead to vastly different practice patterns at different centers. This case series describes the outcomes of patients with Enterococcus bacteremia at a single center.

The Treatment of Enterococcus Blood Stream Infections in Patients Receiving
Methods. A retrospective chart review was performed on all patients who received ECMO support at a tertiary academic medical center with ECMO capabilities between October 2012 and May 2020 with positive blood cultures for Enterococcus species.

Clinical Characteristics of Patients with Enterococcus Bacteremia
Conclusion. Enterococcus is a common cause of blood stream infections in patients with prolonged courses on ECMO circuit. In this cohort of patients, Enterococcus did not cause any metastatic infections and was generally treated with 7-14 days of antibiotics without recurrence, despite many patients remaining on ECMO for extended periods after clearance. As ECMO use continues to expand, there will need to be more data on treatment outcomes of infections to establish best practices.
Disclosures. All Authors: No reported disclosures