e286 13th International Congress on Infectious Diseases Abstracts, Poster Presentations resistance as exemplified by fluconazole and echinocandins- resistant Candida spp. This situation highlights the need for advent of safe, novel and effective antifungal com- pounds. The objective of this study was to determine whether secondary metabolites produced by a species of Streptomyces was able to exert antifungal effects against seven and five medically important yeast Candida spp. and molds Aspergilllus spp. respectively. NCCLS M27A and M38A methods for MIC determination were followed stringently in this screening procedure. Our initial work found all of these fungi were susceptible to the crude fermentative acetone extract (MIC ≤0.625 mg/ml for Candida spp. and ≤2.5 mg/ml for Aspergillus spp.). Five fluconazole-resistant clinical strains were also sensitive to it, with MIC val- ues ≤0.312 mg/ml. In addition, it also totally inhibited C. albicans ATCC 14053 hyphae growth at 0.5mg/ml. These promising results showed that potential antifungal com- pounds from secondary metabolites were produced by this species of Streptomyces. This work will be further tested with fractionated extracts and the mechanism of action of potential bioactive compounds will be elucidated. doi:10.1016/j.ijid.2008.05.766 45.025 Caspofungin Use for the Treatment of Invasive Aspergillosis—Results of a Prospective Observational Registry in the Asia Pacific Region D.G. Lee 1,∗ , W.S. Shin 1 , Y.C. Chen 2 , Y.S. Kim 3 , K.R. Peck 4 , G.C. Wong 5 , S. Chen 6 , Y.C. Liu 7 , M. Shivaprakash 8 1 Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea 2 Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Tai- wan 3 Division of Infectious Diseases, Asan Medical Center, Uni- versity of Ulsan College of Medicine, Seoul, Republic of Korea 4 Division of Infectious Diseases, Samsung Medical Center, Seoul, Republic of Korea 5 Department of Hematology, Singapore General Hospital, Singapore, Singapore 6 Center for Infectious Diseases and Microbiology, Westmead Hospital, New South Wales, Australia 7 Section of Infectious Diseases, Kaohsiung Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan 8 Merck & Co., Inc., Whitehouse Station, NJ, USA Objective: To prospectively assess the Asian-Pacific expe- rience with caspofungin administered as monotherapy or in combination therapy for initial or salvage treatment of proven or probable invasive aspergillosis (IA). Methods: A prospective observational registry was devel- oped to collect data from patients treated with caspofungin for a single episode of IA. Information was collected from patients treated between April 2006 to September 2007. Clinical efficacy was determined by the local investigator as favorable (complete or partial response) or unfavorable (sta- ble disease or treatment failure) at the end of caspofungin therapy (EOCT). Results: Forty one patients with proven or probable IA (EORTC/MSG criteria) were enrolled from 9 sites in 4 countries in the Asian-Pacific region - Australia, Korea, Singapore, and Taiwan. The most frequent underlying con- ditions included malignancy (71%), allogenic hematopoietic stem cell transplantation (HSCT, 30%), solid organ transplan- tation (SOT, 14%) and autologous HSCT (2%). Neutropenia at start of caspofungin was evident in 66% of cases. Eighteen patients (44%) had proven IA and the lung was the most com- mon infection site (73%). In culture-proven cases, Aspergillus fumigatus was the most frequent species. The majority of patients received caspofungin monotherapy (88%), primar- ily as salvage therapy (97%). Most salvage therapy (77%) of monotherapy group occurred in patients refractory to prior antifungals. A favorable response at EOCT was seen in 46% (19/41). Favorable response rates in significant subgroups were: SOT 67% (4/6); allogenic HSCT 42% (5/12); neutrope- nia 37% (10/27); malignancy 35% (10/29). Only 1 serious clinical adverse event (respiratory failure) leading to dis- continuation of drug was reported (2.4%). An overall survival rate was 68% (28/41) at EOCT. Conclusion: In daily clinical practice, an overall favor- able response rate of 46% was observed in patients from Asian-Pacific region with proven or probable IA treated with caspofungin monotherapy or combination therapy which is consistent with the findings observed in randomized clinical trials. doi:10.1016/j.ijid.2008.05.767 45.026 Speciation and Antifungal Susceptibility Patterns of Oropharyngeal Candidiasis among Adult Medical Admis- sions to Mulago Hospital, Kampala J.N. Babirye Makerere University School of Public Health, Kampala, Uganda Introduction: In patients with advanced AIDS, oropharyn- geal candidiasis (OPC) continues to be a common presenting illness associated with significant morbidity. Resistance to antimicrobial agents aggravates the implications for morbid- ity and mortality and health care costs in the hospital and the community. Studies in the USA have shown a correlation between in vitro antifungal susceptibility testing with the clinical outcome. In this study we determine and document the type species and the antifungal susceptibility patterns of organisms causing OPC among HIV+ adult medical admissions to Mulago Hospital, Kampala. Methods: Fifty (50) isolates were obtained from 57 con- secutive isolates among immune suppressed patients at Mulago hospital, Kampala. The isolates were identified using germ tube formation in serum, chlamydospore formation and API20C strips. Antifungal susceptibilities were deter- mined for Nystatin, fluconazole, ketoconazole, miconazole, Itraconazole, 5- flucytocine and voriconazole using calori- metric broth microdilution testing. Results: Ninety percent (90%) of all isolates were C. albi- cans species, 58% of which were isolated from hyperplastic lesions. C. dubliniensis and C. glabrata comprised 6% and 4% of all isolates respectively. Overall the isolates were sensi-