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Background  In February 2019, California (CA) experienced its first  C. auris  outbreak in Orange County (OC). The CA Department of Public Health (CDPH) and OC with the Centers for Disease Control and Prevention (CDC), mounted a successful containment response; by November 2019, cases were limited to low-level spread in OC long-term acute care hospitals (LTACH).  In May 2020,  C. auris  cases began to surge in OC, followed by extensive spread in six other southern CA local health jurisdictions (LHJ). CDPH with LHJ and CDC, initiated an aggressive, interjurisdictional containment response.    Methods  We carried out response and preventive point prevalence surveys (PPS), onsite infection prevention and control (IPC) assessments, and in-service trainings at outbreak and interconnected hospitals and skilled nursing facilities in six LHJ. Other regional activities included: epidemiologic investigation, contact and discharge tracking and screening; increasing laboratory testing capacity; screening patients admitted to and from LTACH; statewide healthcare facility (HCF) education and outreach; sending regional outbreak HCF lists to all HCF; and biweekly state-LHJ coordination calls. The Antibiotic Resistance (AR) Lab Network supported testing.    Results  From May 2020—May 2021, we conducted screening at 226 HCF, and identified 1192 cases at 93 HCF, mostly through screening (n=1109, 93%) and at LTACH (n=906, 76%); we identified 113 (10%) cases at ACH, including 35 (31%) in COVID-19-burdened units. Cases peaked in August 2020 (n=93) and February 2021 (n=191) and have since declined, with  C. auris  resurgence mirroring COVID-19 incidence.  We conducted 98 onsite IPC assessments, and identified multiple, improper IPC practices which had been implemented in response to COVID-19, including double-gloving and -gowning, extended use of gowns and gloves outside patient rooms, and cohorting according to COVID-19 status only.  Figure 1.  C. auris  and COVID-19 Cases in California through May 2021, and  C. auris  Cases by Local Health Jurisdiction (LHJ) May 2020–May 2021Table 1. By Facility Type: Colonization Testing May 2020–May 2021, and Total Case Counts before and from May 2020Table 2. COVID-19-related Infection Control Practices Affecting C. auris Spread, and Associated Public Health RecommendationsConclusion  The  C. auris  resurgence in CA was likely a result of COVID-19-related practices and conditions. An aggressive, coordinated, interjurisdictional  C. auris  containment response, including proactive prevention activities at HCF interconnected with outbreak HCF, can help mitigate spread of  C. auris  and potentially other novel AR pathogens.    Disclosures    All Authors : No reported disclosures

169. The Resurgence of Candida auris in California during the Novel Coronavirus (COVID-19) Pandemic, May 2020–May 2021