Garcia, Bismarck S Bisono

Abstract Background HIV prevention continues to be a care gap in developing countries, like Dominican Republic. The lack of sufficient programs for prescription and information of general populations are barriers for better control of HIV infection in this country. The knowledge of HIV prevention strategies such as Pre-Exposure Prophylaxis (PrEP) or Post-Exposure Prophylaxis (PEP) among medical professionals and medical students is unknown. The goal of ending HIV Pandemic by 2030 is to rely on prevention strategies. Our study aims to determine the level of knowledge of medical students in a pre-preclinical cycle and in a clinical cycle regarding HIV/AIDS, PrEP and PEP Methods We survey medical students in the Dominican Republic to measure knowledge on HIV, PrEP/PEP. We compared mean knowledge for each topic based on a score out of 10. We analyzed mean scores by using T-Tests and ANOVA with Post Hoc or Tukey Analysis, assuming significance when p< 0.05. Results A total of 503 students participated in the survey. ANOVA results showed that there was a statistically significant difference in mean knowledge scores for HIV, PEP, and PrEP (F (2, 1506) = [196.6], p < 0.001). Post hoc analysis revealed that medical students had a higher mean score for HIV knowledge (M= 8.9) than mean scores for PrEP (M= 7.6, p< 0.01) and PEP (M= 7.1, p< 0.01). Similarly, the difference in knowledge scores for PrEP was significantly higher than for PEP (p< 0.01). We further divided participants into Preclinical Years and Clinical years and found that participants within the Clinical Years of Med School had a significantly increased mean PEP knowledge (m= 7.5) than Preclinical Years participants (m= 6.7) (t (460) = 5.8, p< 0.001). Similar results were not appreciated with PrEP, where Clinical year participants had a non-significant increased mean knowledge (m=7.8) compared to their counterparts (m= 7.5) (t (486) = 1.4, p= 0.79). Conclusion Our findings might suggest that medical students acquire more knowledge about PEP as they progress into clinical training, but that PrEP knowledge may be emphasized equally in both pre-clinical and clinical training. Further studies should focus on identifying points for improvement and implementing strategies to tackle barriers. One of several limitations of this study is a response bias. Disclosures All Authors: No reported disclosures

Abstract Background Antimicrobial resistance (AMR) is a threat to healthcare, and infections with antimicrobial resistant organisms carry significant morbidity and mortality. Owing to high rates of AMR, the Centers for Disease Control and Prevention listed Acinetobacter baumannii as a top priority pathogen for research and development of new antimicrobial agents. Antimicrobial susceptibility testing is challenging for this organism, and susceptibility profiles are variable, leading to need of a potential guidance document with assistance in selecting effective empiric therapeutic regimens. Methods We retrospectively reviewed the microbiology and antimicrobial susceptibility testing (AST) results for Acinetobacter spp. from blood culture isolates submitted to Mayo Clinic Laboratories from December 2012 to 2022. AST was performed using agar dilution and interpretations following Clinical & Laboratory Standards Institute (CLSI) guidelines. Isolates were identified by MALDI mass spectrometry and/or 16S sequencing, as available (Figure 1).Figure 1:Isolate identification Isolate identification description. Isolates were analyzed based on this classification used in out laboratory. Results 804 blood culture isolates were included. A. baumannii/calcoaceticus complex (27%) was most frequently isolated, followed by A. lwoffii (22%), and showed the highest resistance across all antimicrobials (73% susceptible or below) (Figure 2). A. baumannii/calcoaceticus complex showed rising resistance rates over time from 2012 to 2022 for meropenem, minocycline and ampicillin-sulbactam (Figure 3). Cefiderocol non-susceptible rate was 35% for A. baumannii/calcoaceticus complex.Figure 2:Antimicrobial susceptibility profiles for Acinetobacter spp. Description of susceptibility profiles for Acinetobacter spp. isolates, based on the classification used by our laboratory. Antimicrobials are presented at the top and isolates on the left. Number of isolates analyzed are presented in the table with the percentage of the isolates susceptible to each antibiotic class in parenthesis.Figure 3:Acinetobacter baumannii/calcoaceticus complex isolates and resistance, trend Trend of isolates per year and resistance percentage to meropenem, colistin, minocycline and amp-sulb. Number of isolates per year at the base of each bar; percentage of resistance for antimicrobials expressed on lines. Amp-sulb = ampicillin-sulbactam. Conclusion A. baumannii/calcoaceticus complex showed high levels of resistance ( >75%) across multiple antimicrobials and increasing rates of resistance over time from 2012 to 2022. A high number of cefiderocol non-susceptible organisms is also concerning (Figure 2). Disclosures Audrey N. Schuetz, MD, Merck: Advisor/Consultant

Abstract Background HIV knowledge and prevention strategies, like PrEP/PEP is a core element in current medical practice but represents a challenge for medical students’ curricula. In countries like Dominican Republic (DR), the stigma towards HIV infection restricts the delivery of HIV related information to the general population. Our study aims to understand the level of knowledge between different academical years pose regarding HIV/AIDS, PrEP and PEP and how their curricula content is covered across the years. Methods We survey medical students in the DR to measure knowledge on HIV, PrEP/PEP. Students who agreed to participate filled in a survey with 3 sections. Each section had 10 true or false questions. Responses were compared mean knowledge for each topic based on a score out of 10. We analyzed mean scores using ANOVA with Post Hoc analysis, assuming significance when p< 0.05. Results A total of 503 participants participated in the survey. ANOVA results showed that there was a statistically significant difference in mean HIV knowledge (F (3, 499) = [25,58], p< 0.001) and PEP knowledge (F (3, 499) = [13,77], p< 0.001) between the academical years. Post-hoc analysis revealed that MS4 had a higher mean score for HIV knowledge (M= 9.3) than MS2 (8.7, p< 0.01) and MS1 (m= 8.2, p< 0.01). Similarly, MS3 had a higher mean HIV knowledge than MS2 (p< 0.01) and MS1 (p< 0.01). Likewise, MS2 had an increased mean HIV knowledge when compared to MS1 (p< 0.01). When we compare mean PEP knowledge, we found that MS3 (m= 7.45) had increased knowledge than MS1 (6.4, p< 0.01) and MS2 (m= 6.9, p< 0.05). Similarly, we found that MS4 had increased mean PEP Knowledge (m= 7.5) when compared to MS1 and MS2 (p< 0.001). When we studied mean PrEP knowledge, ANOVA analysis found no significant difference (F (3, 499) = [1,24], p= 0.29). Conclusion Our study suggests that the mean knowledge of HIV and PEP increases throughout the academic progression of medical school. Although there is no difference in PEP knowledge, this may suggest that medical schools are teaching PEP during MS3-MS4 cycle rather than the M1-M2 cycle. Also, the homogenous mean PrEP knowledge could suggest that the students are learning from non-academic sources. This emphasizes the curricular designers of medical schools to review the contents on prevention of communicable diseases. Disclosures All Authors: No reported disclosures