147. Defining the Optimal Serial Testing Interval and Features for Identifying Patients with Early SARS-CoV-2 Infection

Background Serial testing for SARS-CoV-2 is necessary to prevent spread from patients early in infection. Testing intervals are largely derived from viral kinetic studies performed early in the COVID-19 pandemic. Laboratory and epidemiologic data accrued over the past year present an opportunity to use empiric models to define optimal serial testing intervals and features predictive of early infection. Methods Retrospective analysis of 15,314 inpatients within the Mass General Brigham healthcare system who had two tests within a 36-hour period between May 1 2020 and May 29 2021. Early infection was defined as having a negative test followed by a positive test. Patients with prior positive tests were excluded. The primary outcome was the proportion of patients in early infection over the total number tested serially, stratified by 4-hour testing intervals from the timestamp of the first test. Multivariate modeling was used to identify features predictive of early infection. Covariates included demographics, body site, PCR assay, location, community incidence, percent positivity, and median / skew of Ct value distributions. Results Of 19,971 test pairs, 193 (0.97%) were characterized as a negative followed by a positive within 36 hours. Bivariate analysis showed a close association between negative to positive test pairs during the first surge in spring 2020 that was not present during the winter surge. Negative to positive test pairs were most common in the 12 to 16 hour time interval (51/193, 26%, Figure 1). After controlling for covariates, the Roche cobas assay was more likely to identify patients with a negative to positive test pair relative to the Cepheid Xpert, Hologic Panther Fusion and Roche Liat assays. A second specimen from the lower respiratory tract was more likely to lead to a positive relative to other body sites. Community incidence and Ct value distributions were not predictive and there were no differences between nasal and nasopharyngeal swabs. All 4-hour time intervals from 16 to 36 hours were significant for predicting a negative to positive test pair (Table 1). Figure 1. Distribution of negative to positive test pairs by 4 hour time intervals Table 1. Multivariate regression predicting a negative to positive test pair Conclusion The likelihood of detecting early infection is dependent on PCR platform and body site of sampling. A range of time intervals between 16 to 36 hours after the initial test were likely to identify positive cases. Disclosures Sanjat Kanjilal, MD, MPH, GlaskoSmithKline (Advisor or Review Panel member)

Chronic Diseases Associated with Malassezia Yeast

Malassezia are a lipid-dependent basidiomycetous yeast of the normal skin microbiome, although Malassezia DNA has been recently detected in other body sites and has been associated with certain chronic human diseases. This new perspective raises many questions. Are these yeasts truly present in the investigated body site or were they contaminated by other body sites, adjacent or not? Does this DNA contamination come from living or dead yeast? If these yeasts are alive, do they belong to the resident mycobiota or are they transient colonizers which are not permanently established within these niches? Finally, are these yeasts associated with certain chronic diseases or not? In an attempt to shed light on this knowledge gap, we critically reviewed the 31 published studies focusing on the association of Malassezia spp. with chronic human diseases, including psoriasis, atopic dermatitis (AD), chronic rhinosinusitis (CRS), asthma, cystic fibrosis (CF), HIV infection, inflammatory bowel disease (IBD), colorectal cancer (CRC), and neurodegenerative diseases.

Chronic Diseases Associated with Malassezia Yeast

Malassezia are lipid-dependent basidiomycetous yeast of the normal skin microbiome, although Malassezia DNA has been recently detected in other body sites and has been associated with cer-tain chronic human diseases. This new perspective raises many questions. Are these yeasts truly present in the investigated body site or were they contaminated by other body sites, adjacent or not? Does this DNA contamination come from living or dead yeast? If these yeasts are alive, do they belong to the resident mycobiota or are they transient colonizers which are not permanently established within these niches? And, finally, are these yeasts associated with certain chronic diseases or not? In an attempt to shed light on this knowledge gap, we critically re-viewed the 31 published studies focusing on the association of Malassezia spp. with chronic human diseases, including psoriasis, atopic dermatitis (AD), chronic rhinosinusitis (CRS), asthma, cystic fibrosis (CF), HIV infection, inflammatory bowel disease (IBD), colorectal cancer (CRC), and neurodegenerative diseases.

601Is in-situ melanoma a precursor of invasive melanoma; a New Zealand study

Background Melanoma is diagnosed as either in-situ or invasive disease. The relationship between the two diseases is unclear. If every in-situ is an early stage of invasive melanoma, diagnosis and removal of in-situ lesions should reduce the incidence of invasive melanoma. If the association is more complex, the excision of in-situ lesions might not effectively prevent invasive disease and may represent overdiagnosis. Methods A population-based cohort study involved all patients diagnosed with either in-situ or invasive melanoma from the New Zealand Cancer Registry between 2001 and 2017. The pattern of in-situ and invasive melanoma was compared by incidence, trends, and key patient characteristics (age at diagnosis, sex, body site, and ethnicity). Results The incidence of in-situ melanoma increased annually by 3.77% whereas that of invasive melanoma was relatively stable (annual increase 0.04%) over the study period. The pattern of in-situ and invasive melanoma was similar by sex and ethnicity but differed by body site. Since the distribution of melanoma for age at diagnosis was highly influenced by body site and sex, it was difficult to compare between the two diseases. The observed risk of invasive melanoma among in-situ cohort was four times higher than that expected among general population. Conclusions Not every in-situ was a precursor of invasive melanoma, but some did progress to an invasive lesion. Key-messages Plans should be considered to compare the potential harms and benefits of the screening and excision of in-situ melanoma.

Does the Site of Blood Collection in Fish Affect Haematological and Blood Biochemical Results?

The values of haematological and selected blood plasma biochemical parameters of juvenile common carp (Cyprinus carpio Linnaeus, 1758) were compared between blood samples taken from caudal vein and heart to evaluate the influence of blood sampling body site on the obtained results in two groups of fish of different blood sampling order: I – first by caudal and then by cardiac puncture, II – first by cardiac and then by caudal puncture. The obtained results revealed statistically significant (p<0.05) differences only in group I where red blood cell (RBC) count was higher in caudal vein blood, while haematocrit (Ht) value, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), total protein (TP) concentration, and magnesium (Mg) level were higher in cardiac blood samples. No statistically significant differences occurred in white blood cell (WBC) count, differential leukocyte count or erythrocyte morphology based on stained blood smears. The obtained results showed that blood sampling body site may affect the results of haematological and plasma biochemical analyses.

Body Odours Sampled at Different Body Sites in Infants and Mothers—A Comparison of Olfactory Perception

Body odours and their importance for human chemical communication, e.g., in the mother–child relationship, are an increasing focus of recent research. Precise examination of sampling methods considering physiology and feasibility aspects in order to obtain robust and informative odour samples is therefore necessary. Studies comparing body odour sampling at different body sites are still pending. Therefore, we sampled axilla, breast, and head odour from 28 mother–infant dyads and examined whether odour perception differs with regard to the body site. The participating mothers were asked to evaluate their own and their infant’s body odour samples, as well as odours of two unfamiliar mother–infant dyads. We tested whether maternal pleasantness and intensity evaluation, as well as recognition ability of the odours differed between the body sites. In infants, the head odour exhibited slightly lower pleasantness ratings than axilla and breast, and intensity ratings did not differ between body sites. In mothers, body site affected intensity ratings but not pleasantness ratings, as the breast odour was rated as less intense compared with head and axilla. Across all body sites, mothers rated the own and their infant’s odour as less intense when compared with unfamiliar samples. Recognition ability did not differ between body sites, and in line with previous studies, mothers were able to recognize their own and their own infant’s odour above chance. In sum, our study extends the previous methodological repertoire of body odour sampling and indicates that the axilla, breast, and head of adults as well as infants serve as informative odour sources.