Poster Abstracts OFID 2018 5 Suppl 1 S495 Truncating the duration of empiric prophylactic antibiotics reduces unnecessary antibiotic use Disclosures All authors No reported disclosures 1583 The Utility of the Immunodeficiency Scoring Index ISI to Predict Outcomes of Coronavirus HCoV Infections in Hematopietic Cell Transplant HCT Recipients Fareed Khawaja MD 1 Terri Lynn Shigle PharmD BCPS BCOP 2 Shashank S Ghantoji MD PhD MPH 3 Marjorie Batista MD PhD 4 Ella Ariza Heredia MD 4 and Roy F Chemaly MD MPH FIDSA FACP 5 1 Department of Infectious Diseases The University of Texas Health Science Center at Houston Houston Texas 2 Division of Pharmacy The University of Texas MD Anderson Cancer Center Houston Texas 3 Infectious Diseases The University of Texas MD Anderson Cancer Center Houston Texas 4 The University of Texas MD Anderson Cancer Center Houston Texas 5 Department of Infectious Diseases Infection Control in this sample the mutation was either not detected detected as minority or dominating variant for 11 7 and 2 respectively In the majority of recipients one dominant mutant was induced 68 2 mutations were detected in the remaining recipients Table 1 Most frequent UL97 GCV R affected codon 595 42 594 32 or 603 32 The of C592G was low in in all episodes 15 without changing during the course Figure 1 There was a trend toward higher frequencies of donor D recip ient R CMV high risk mismatch CMV disease and prior failure to valganciclo vir prophylaxis SOT or treatment HCT among the cases with UL97 GCV R Figure 2 Conclusion UL97 GCV R was seen in 22 of refractory CMV replication epi sodes CMV D R mismatch and CMV disease were more common amongst resistant cases The C592G mutation was present in low frequency in all patients suggesting that this mutation was part of the quasispecies and not selected by ganciclovir resistance Implications for clinical management will be discussed Downloaded from by guest on 11 April 2019