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Background Hurricane Harvey caused record flooding in late August 2017. As flood damage causes mold overgrowth, excess rates of IMIs in immunocompromised cancer patients is of concern. Methods We compared the rates (patient-1,000 days) of cIMIs (EORTC/MSG criteria), in the period 7 months preceding and 7 months following hurricane Harvey, diagnosed in cancer patients at our institution. We focused on the four molds (Aspergillus, Fusarium, Mucorales, Scedosporium) that account for the vast majority of cIMIs in our patient population. Results No changes in cIMI rates (0.184 pre-Harvey vs. 0.171 post–Harvey, P = NS) and mold distribution as causes of cIMIs were seen (table). No increased cases of cIMIs were encountered amongst different services (table), including patients with lymphoma/multiple myeloma or solid tumors (40% pre-Harvey vs. 31% post-Harvey, P = NS). Conclusion Despite concerns for extensive environmental mold exposure after hurricane Harvey, we did not detect increased rates of cIMIs nor the emergence of unusual molds as causes of IMIs in high-risk cancer patients at MDACC, including in patients with solid tumors, where mold-active prophylaxis is not used. Whether excess IMI cases not fitting the traditional diagnostic criteria (e.g., biomarker-positive but culture-negative IMIs) or pneumonias not requiring hospitalization were seen, requires further study. Inpatient Hospital Infection Rates 7 Months Pre Harvey Inpatient Hospital Infection Rates 7 Months Post Harvey Aspergillus 0.1506 0.1621 Mucorales 0.0167 0.0000 Fusarium 0.0167 0.0085 Scedosporium 0.0000 0.0000 Total 0.1840 0.1706 Inpatient Service Line Infection Rates 7 Months Pre Harvey Inpatient Service Line Infection Rates 7 Months Pre Harvey MM/Lymphoma 0.3185 0.2441 Solid Tumor 0.0588 0.0594 Leukemia 0.3655 0.5052 Stem Cell Transplant 0.1835 0.184 Disclosures D. P. Kontoyiannis, Merck: Consultant, Research support and Speaker honorarium. Pfizer: Consultant, Research support. Astellas: Consultant, Research support and Speaker honorarium. Gilead: Speaker’s Bureau, Speaker honorarium. F2G Inc.: Speaker’s Bureau, Speaker honorarium. Cidara Inc.: Speaker’s Bureau, Speaker honorarium. Jazz Pharmaceuticals: Speaker’s Bureau, Speaker honorarium. I. Raad, The University of Texas MD Anderson Cancer Center: Shareholder, Licensing agreement or royalty. The Unversity of Texas MD Anderson Cancer Center: Shareholder, Dr. Raad is a co-inventor of the Nitroglycerin-Citrate-Ethanol catheter lock solution technology which is owned by the University of Texas MD Anderson Cancer Center (UTMDACC) and has been licensed to Novel Anti-Infective Technologies LLC, in which UTMDACC and Licensing agreement or royalty.

416. Culture-Documented Invasive Mold Infections (cIMIs) at MD Anderson Cancer Center (MDACC) in Houston, Texas Pre- and Post-Hurricane Harvey