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Background Graduate medical education programs shifted to an all-virtual recruitment in 2020. There is little published on the impact of this shift on the demographics of applicants, particularly in a field such as infectious disease where there are typically fewer applicants than available spots. Program directors were forced to make a radical change to their typical recruitment process. This study illustrates a single-center experience with virtual ID fellowship interviewing. Methods Using the Program Director Work Station on Electronic Residency Application Service (ERAS), we reviewed our program specific data from 2018-2021. We extracted the total number of applicants, the self-identified race/ethnicity of the applicants, their medical school type (US MD grad, DO grad, Non-US grad), their sex, and their location. We used simple descriptive statistics to identify trends and comparisons from in-person interviewing (2018 and 2019) and virtual interviewing (2020 and 2021). Results The number of virtual ID fellowship applicants to our program increased in 2021 by 24% compared to in-person applicants in 2019 (123 vs. 99). This exceeds what a program would expect from the 13% nation-wide increase in ID applicants in 2021 as there were a record 404 total applicants compared to 356 total applicants in 2019 We also saw an increase in Black or African American applicants; 13 Black applicants in 2021 compared to 2 Black applicants in 2019. We saw a stable rate of applicants who self-identified Hispanic, Latino, or of Spanish origin; 18 in 2019 and 17 in 2021. as Notably, we also saw an increase in geographic diversity of our applicants as we drew applicants from 22 states in 2019 (Figure 1a) and 35 states in 2021 (Figure 1b). Additionally, in 2020 we matched two applicants from geographically distant states (Ohio and Colorado) and in 2021 we matched one (Mississippi). Figure 1aFigure 1b Conclusion Virtual interviewing was advantageous for our infectious disease fellowship program at Temple University. We saw a 24% increase in applicants, had more Black applicants and more geographic diversity in our applicants. Furthermore, we were able to recruit these applicants into matched fellows. Disclosures All Authors: No reported disclosures.

BACKGROUND: Due to the ongoing opioid epidemic in the United States, deceased organ donors increasingly have a history of injection drug use (IDU), raising concerns about infectious risks to solid organ transplant (SOT) recipients. We sought to determine how recent IDU among deceased organ donors impacted donor culture results and recipient outcomes. METHODS: A retrospective cohort study was performed at three transplant centers. Exposed donors were those with “recent IDU” (in the prior 12 months). Primary outcomes included (1) positive donor cultures for bacteria or Candida species, (2) recipient bacterial or Candida infection within 3 months posttransplant, and (3) recipient graft failure or death within 12 months posttransplant. Mixed effects multivariable regression models were used to evaluate the relationship between recent donor IDU and each outcome. RESULTS: A total of 658 SOT recipients who received organs from 394 donors were included. Sixty-six (17%) donors had a history of recent IDU. Recent IDU in donors was associated with a significantly increased odds of donor culture positivity (aOR 3.65, 95% CI 1.06–12.60, p = .04) but was not associated with SOT recipient infection (aHR 0.98, 95% CI 0.71–1.36, p = .92) or graft failure or death (aHR 0.67, 95% CI 0.29–1.51, p = .33). CONCLUSION: Donors with recent IDU are more likely to have positive cultures, but their recipients’ outcomes are unaffected, suggesting organs from donors with recent IDU may be safely utilized.

Background Risk factors for acquisition of vancomycin-resistant Enterococcus (VRE) include immunosuppression, antibiotic exposure, indwelling catheters, and manipulation of the gastrointestinal tract, all of which occur in liver transplant recipients. VRE infections are documented in liver transplantation (LT); however, only one single center study has assessed the impact of daptomycin-resistant Enterococcus (DRE) in this patient population. Methods We conducted a retrospective multicenter cohort study comparing liver transplant recipients with either VRE or DRE bacteremia. The primary outcome was death within 1 year of transplantation. Multivariable logistic regression analyses were performed to calculate adjusted odds ratios for outcomes of interest. Results We identified 139 cases of Enterococcus bacteremia following LT, of which 78% were VRE and 22% were DRE. When adjusted for total intensive care unit days in the first transplant year, liver-kidney transplantation, and calcineurin inhibitor use, patients with DRE bacteremia were 2.65 times more likely to die within 1 year of transplantation (adjusted odds ratio [aOR], 2.648; 95% CI, 1.025–6.840; P = .044). Prior daptomycin exposure was found to be an independent predictor of DRE bacteremia (aOR, 30.62; 95% CI, 10.087–92.955; P Conclusions In this multicenter study of LT recipients with Enterococcus bacteremia, DRE bacteremia was associated with higher 1-year mortality rates when compared with VRE bacteremia. Our data provide strong support for dedicated infection prevention and antimicrobial stewardship efforts for transplant patients. Further research is needed to support the development of better antibiotics for DRE and practical guidance focusing on identification and prevention of colonization and subsequent infection in liver transplant recipients at high risk for DRE bacteremia.