In Vitro Activity Of Ceftaroline And Comparators Against Staphylococcus aureus Isolates: Results From 6 Years Of The ATLAS Program (2012 To 2017)

Figures & data

Table 1 In Vitro Activity Of Ceftaroline Tested Against Isolates Of Staphylococcus aureus

Organism(No. Of Isolates Tested)	Ceftaroline MIC (mg/L)			CLSI MIC Interpretation			EUCAST MIC Interpretation
	MIC50	MIC90	MIC Range	% Susceptible	% SDD	% Resistant	% Susceptible	% SDD	% Resistant
S. aureus (61,045)	0.5	1	0.015–64	93.7	5.9	0.4	93.7	5.9	0.4
MRSA (35,837)	0.5	2	0.015–64	89.3	10.0	0.7	89.3	10.0	0.7
MSSA (25,208)	0.25	0.25	0.015–2	>99.9	<0.1	0	>99.9	<0.1	0

Abbreviations: MIC, minimal inhibitory concentration; CLSI, Clinical and Laboratory Standards Institute; EUCAST, European Committee on Antimicrobial Susceptibility Testing; SDD, susceptible-dose dependent; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-sensitive Staphylococcus aureus.

Table 2 Susceptibilities Of Staphylococcus aureus To Ceftaroline And Comparators From 2012 To 2017

Variable	% Susceptible To Antimicrobial Agents: CLSI/EUCAST (No. Of Isolates Tested)
	All Years	2012	2013	2014	2015	2016	2017
S. aureus
Ceftaroline	93.7/93.7 (61,045)	92.7/92.7 (8,827)	92.5/92.5 (11,680)	93.4/93.4 (11,191)	93.9/93.9 (10,158)	95.1/95.1 (10,682)	94.7/94.7 (8,507)
Clindamycin	75.6/75.0 (61,045)	73.8/73.0 (8,827)	74.9/74.3 (11,680)	74.4/74.1 (11,191)	76.0/75.6 (10,158)	75.8/75.0 (10,682)	78.8/78.4 (8,507)
Daptomycin	99.8/99.8 (61,045)	>99.9/>99.9 (8,827)	99.4/99.4 (11,680)	99.7/99.7 (11,191)	99.8/99.8 (10,158)	99.9/99.9 (10,682)	99.9/99.9 (8,507)
Erythromycin	49.5/51.9 (61,045)	42.3/48.4 (8,827)	46.6/51.3 (11,680)	50.1/51.7 (11,191)	51.3/52.0 (10,158)	50.7/51.3 (10,682)	56.3/57/0 (8,507)
Gentamicin	85.3/61.8 (40,538)	-/- (0)	-/- (0)	84.7/1.8 (11,191)	85.4/84.9 (10,158)	85.2/84.2 (10,682)	85.9/85.2 (8,507)
Levofloxacin	57.8/57.8 (61,045)	55.4/55.4 (8,827)	57.1/57.1 (11,680)	56.5/56.5 (11,191)	58.6/58.6 (10,158)	58.8/58.8 (10,682)	60.5/60.5 (8,507)
Linezolid	>99.9/>99.9 (61,045)	100/100 (8,827)	>99.9/>99.9 (11,680)	>99.9/>99.9 (11,191)	100/100 (10,158)	99.9/99.9 (10,682)	>99.9/>99.9 (8,507)
Minocycline	93.6/89.9 (61,045)	91.3/86.0 (8,827)	93.0/86.4 (11,680)	94.3/91.8 (11,191)	94.4/91.8 (10,158)	93.6/91.1 (10,682)	95.2/92.6 (8,507)
Moxifloxacin	58.0/57.7 (61,045)	55.9/55.1 (8,827)	57.3/57.1 (11,680)	56.8/56.5 (11,191)	58.8/58.4 (10,158)	58.9/58.6 (10,682)	60.6/60.4 (8,507)
Oxacilin	41.3/- (61,045)	40.5/- (8,827)	42.9/- (11,680)	40.7/- (11,191)	39.8/- (10,158)	40.4/- (10,682)	43.6/- (8,507)
Teicoplanin	>99.9/98.3 (61,045)	>99.9/98.8 (8,827)	99.9/97.3 (11,680)	>99.9/98.6 (11,191)	>99.9/97.6 (10,158)	100/98.7 (10,682)	100/98.9 (8,507)
Tigecycline	99.0/99.0 (61,045)	99.5/99.5 (8,827)	97.8/97.8 (11,680)	98.1/98.1 (11,191)	99.7/99.7 (10,158)	99.8/99.8 (10,682)	99.6/99.6 (8,507)
TMP-SMX	96.7/96.7 (40,538)	-/- (0)	-/- (0)	96.5/96.5 (11,191)	96.9/96.9 (10,158)	96.5/96.5 (10,682)	96.8/96.8 (8,507)
Vancomycin	>99.9/>99.9 (61,045)	100/100 (8,827)	100/100 (11,680)	>99.9/>99.9 (11,191)	>99.9/>99.9 (10,158)	100/100 (10,682)	100/100 (8,507)
MRSA
Ceftaroline	89.3/89.3 (35,837)	87.7/87.7 (5,253)	86.8/86.8 (6,666)	89.0/89.0 (6,638)	89.9/89.9 (6,112)	91.8/91.8 (6,371)	90.6/90.6 (4,797)
Clindamycin	61.7/61.1 (35,837)	59.3/58.7 (5,253)	59.8/59.3 (6,666)	59.8/59.5 (6,638)	63.4/62.9 (6,112)	62.9/61.9 (6,371)	65.7/65.1 (4,797)
Daptomycin	99.7/99.7 (35,837)	99.9/99.9 (5,253)	99.3/99.3 (6,666)	99.7/99.7 (6,638)	99.8/99.8 (6,112)	>99.9>99.9 (6,371)	99.8/99.8 (4,797)
Erythromycin	31.0/32.5 (35,837)	23.8/27.2 (5,253)	26.3/29.4 (6,666)	30.6/31.8 (6,638)	33.8/34.3 (6,112)	33.2/33.7 (6,371)	39.3/39.7 (4,797)
Gentamicin	78.4/56.6 (23,918)	-/- (0)	-/- (0)	77.5/1.1 (6,638)	78.8/78.3 (6,112)	78.5/77.5 (6,371)	79.0/78.0 (4,797)
Levofloxacin	32.9/32.9 (35,837)	29.6/29.6 (5,253)	29.9/29.9 (6,666)	31.0/31.0 (6,638)	35.5/35.5 (6,112)	36.3/36.3 (6,371)	35.8/35.8 (4,797)
Linezolid	>99.9/>99.9 (35,837)	100/100 (5,253)	>99.9/>99.9 (6,666)	100/100 (6,638)	100/100 (6,112)	99.9/99.9 (6,371)	>99.9/>99.9 (4,797)
Minocycline	89.9/85.0 (35,837)	86.2/80.2 (5,253)	88.5/79.9 (6,666)	91.4/88.1 (6,638)	91.2/87.4 (6,112)	89.9/86.3 (6,371)	92.5/88.5 (4,797)
Moxifloxacin	33.1/32.8 (35,837)	29.9/29.3 (5,253)	30.1/29.9 (6,666)	31.4/31.0 (6,638)	35.6/35.4 (6,112)	36.4/36.1 (6,371)	35.9/35.7 (4,797)
Oxacilin	0/- (35,837)	0/- (5,253)	0/- (6,666)	0/- (6,638)	0/- (6,112)	0/- (6,371)	0/- (4,797)
Teicoplanin	>99.9/97.3 (35,837)	99.9/98.1 (5,253)	99.9/96.1 (6,666)	>99.9/97.8 (6,638)	>99.9/96.2 (6,112)	100/98.0 (6,371)	100/98.2 (4,797)
Tigecycline	98.7/98.7 (35,837)	99.4/99.4 (5,253)	96.8/96.8 (6,666)	97.7/97.7 (6,638)	99.5/99.5 (6,112)	99.61/99.6 (6,371)	99.3/99.3 (4,797)
TMP-SMX	95.5/95.5 (23,918)	-/- (0)	-/- (0)	95.3/95.3 (6,638)	95.7/95.7 (6,112)	95.2/95.2 (6,371)	95.8/95.8 (4,797)
Vancomycin	>99.9/>99.9 (35,837)	100/100 (5,253)	100/100 (6,666)	>99.9/>99.9 (6,638)	>99.9/>99.9 (6,112)	100/100 (6,371)	100/100 (4,797)
MSSA
Ceftaroline	>99.9/>99.9 (25,208)	99.9/99.9 (3,574)	>99.9/>99.9 (5,014)	99.9/99.9 (4,553)	100/100 (4,046)	100/100 (4,311)	100/100 (3,710)
Clindamycin	95.3/94.7 (25,208)	95.1/94.0 (3,574)	95.0/94.3 (5,014)	95.7/95.3 (4,553)	95.1/94.7 (4,046)	95.0/94.3 (4,311)	95.8/95.7 (3,710)
Daptomycin	99.9/99.9 (25,208)	100/100 (3,574)	99.6/99.6 (5,014)	99.8/99.8 (4,553)	>99.9/>99.9 (4,046)	99.9/99.9 (4,311)	>99.9/>99.9 (3,710)
Erythromycin	75.8/79.4 (25,208)	69.5/79.5 (3,574)	73.5/80.4 (5,014)	78.5/80.8 (4,553)	77.7/78.6 (4,046)	76.5/77.2 (4,311)	78.4/79.4 (3,710)
Gentamicin	95.2/69.3 (16,620)	-/- (0)	-/- (0)	95.3/2.6 (4,553)	95.3/94.9 (4,046)	95.2/94.2 (4,311)	94.8/94.5 (3,710)
Levofloxacin	93.0/93.0 (25,208)	93.3/93.3 (3,574)	93.2/93.2 (5,014)	93.7/93.7 (4,553)	93.5/93.5 (4,046)	92.1/92.1 (4,311)	92.4/92.4 (3,710)
Linezolid	100/100 (25,208)	100/100 (3,574)	100/100 (5,014)	>99.9/>99.9 (4,553)	100/100 (4,046)	100/100 (4,311)	100/100 (3,710)
Minocycline	98.9/96.9 (25,208)	98.8/94.6 (3,574)	99.0/95.1 (5,014)	98.7/97.2 (4,553)	99.2/98.4 (4,046)	99/98.4 (4,311)	98.5/97.8 (3,710)
Moxifloxacin	93.3/92.9 (25,208)	94.1/93.0 (3,574)	93.4/93.2 (5,014)	93.8/93.6 (4,553)	93.7/93.3 (4,046)	92.1/91.9 (4,311)	92.5/92.4 (3,710)
Oxacilin	100/- (25,208)	100/- (3,574)	100/- (5,014)	100/- (4,553)	100/- (4,046)	100/- (4,311)	100/- (3,710)
Teicoplanin	>99.9/99.6 (25,208)	100/99.8 (3,574)	>99.9/98.8 (5,014)	100/99.8 (4,553)	100/99.8 (4,046)	100/99.8 (4,311)	100/99.8 (3,710)
Tigecycline	99.5/99.5 (25,208)	99.6/99.6 (3,574)	99.2/99.2 (5,014)	98.7/98.7 (4,553)	99.9/99.9 (4,046)	100/100 (4,311)	>99.9/>99.9 (3,710)
TMP-SMX	98.4/98.4 (16,620)	-/- (0)	-/- (0)	98.3/98.3 (4,553)	98.6/98.6 (4,046)	98.5/98.5 (4,311)	98.2/98.2 (3,710)
Vancomycin	100/100 (25,208)	100/100 (3,574)	100/100 (5,014)	100/100 (4,553)	100/100 (4,046)	100/100 (4,311)	100/100 (3,710)

Abbreviations: CLSI, Clinical and Laboratory Standards Institute; EUCAST, European Committee on Antimicrobial Susceptibility Testing; TMP-SMX, trimethoprim-sulfamethoxazole; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-sensitive Staphylococcus aureus.

Table 3 Susceptibilities Of Staphylococcus aureus To Ceftaroline And Comparators In Different Regions

Variable	% Susceptible To Antimicrobial Agents: CLSI/EUCAST (No. Of Isolates Tested)
	All Regions	The United States	Europe	Asia-Pacific	South America	Africa-West Asia
S. aureus
Ceftaroline	93.7/93.7 (61,045)	99.7/99.7 (6,560)	96.6/96.6 (28,462)	85.0/85.0 (12,855)	91.3/91.3 (8,471)	95.7/95.7 (4,697)
Clindamycin	75.6/75.0 (61,045)	78.0/77.7 (6,560)	80.0/79.2 (28,462)	65.0/64.6 (12,855)	73.0/72.8 (8,471)	78.5/78.0 (4,697)
Daptomycin	99.8/99.8 (61,045)	99.9/99.9 (6,560)	99.7/99.7 (28,462)	99.8/99.8 (12,855)	99.9/99.9 (8,471)	99.9/99.9 (4,697)
Erythromycin	49.5/51.9 (61,045)	25.9/28.1 (6,560)	54.0/56.6 (28,462)	47.0/49.1 (12,855)	53.1/55.4 (8,471)	55.4/57.7 (4,697)
Gentamicin	85.3/61.8 (40,538)	97.1/60.4 (3,800)	91.2/65.7 (19,188)	69.3/55.2 (8,289)	84.3/61.6 (6,022)	79.0/57.6 (3,239)
Levofloxacin	57.8/57.8 (61,045)	49.5/49.5 (6,560)	54.7/54.7 (28,462)	61.3/61.3 (12,855)	69.8/69.8 (8,471)	56.5/56.5 (4,697)
Linezolid	>99.9/>99.9 (61,045)	>99.9/>99.9 (6,560)	>99.9/>99.9 (28,462)	>99.9/>99.9 (12,855)	100/100 (8,471)	>99.9/>99.9 (4,697)
Minocycline	93.6/89.9 (61,045)	97.6/95.1 (6,560)	95.9/92.7 (28,462)	82.3/76.0 (12,855)	99.4/98.0 (8,471)	95.2/89.4 (4,697)
Moxifloxacin	58.0/57.7 (61,045)	49.6/49.4 (6,560)	54.9/54.5 (28,462)	61.5/61.2 (12,855)	70.1/69.8 (8,471)	56.6/56.4 (4,697)
Oxacilin	41.3/- (61,045)	32.4/- (6,560)	43.5/- (28,462)	37.9/- (12,855)	44.5/- (8,471)	44.1/- (4,697)
Teicoplanin	>99.9/98.3 (61,045)	100/99.6 (6,560)	>99.9/98.8 (28,462)	>99.9/95.8 (12,855)	>99.9/99.0 (8,471)	>99.9/99.1 (4,697)
Tigecycline	99.0/99.0 (61,045)	99.7/99.7 (6,560)	99.4/99.4 (28,462)	96.9/96.9 (12,855)	>99.9/>99.9 (8,471)	99.9/99.9 (4,697)
TMP-SMX	96.7/96.7 (40,538)	96.8/96.8 (3,800)	98.3/98.3 (19,188)	93.0/93.0 (8,289)	99.0/99.0 (6,022)	92.2/92.2 (3,239)
Vancomycin	>99.9/>99.9 (61,045)	>99.9/>99.9 (6,560)	>99.9/>99.9 (28,462)	>99.9/>99.9 (12,855)	100/100 (8,471)	100/100 (4,697)
MRSA
Ceftaroline	89.3/89.3 (35,837)	99.5/99.5 (4,435)	94.0/94.0 (16,087)	75.9/75.9 (7,989)	84.4/84.4 (4,700)	92.3/92.3 (2,626)
Clindamycin	61.7/61.1 (35,837)	70.3/70.1 (4,435)	67.4/66.5 (16,087)	49.6/49.2 (7,989)	53.8/53.5 (4,700)	62.8/62.4 (2,626)
Daptomycin	99.7/99.7 (35,837)	99.9/99.9 (4,435)	99.6/99.6 (16,087)	99.8/99.8 (7,989)	99.9/99.9 (4,700)	99.9/99.9 (2,626)
Erythromycin	31.0/32.5 (35,837)	10.9/11.9 (4,435)	34.7/36.5 (16,087)	29.8/31.3 (7,989)	35.8/37.2 (4,700)	36.8/38.0 (2,626)
Gentamicin	78.4/56.6 (23,918)	96.4/59.9 (2,574)	86.7/62.8 (11,021)	56.8/45.6 (5,195)	76.4/54.7 (3,290)	68.3/49.0 (1,838)
Levofloxacin	32.9/32.9 (35,837)	31.9/31.9 (4,435)	25.0/25.0 (16,087)	41.6/41.6 (7,989)	48.5/48.5 (4,700)	29.5/29.5 (2,626)
Linezolid	>99.9/>99.9 (35,837)	>99.9/>99.9 (4,435)	>99.9/>99.9 (16,087)	>99.9/>99.9 (7,989)	100/100 (4,700)	>99.9/>99.9 (2,626)
Minocycline	89.9/85.0 (35,837)	97.2/94.2 (4,435)	93.5/89.4 (16,087)	72.4/63.8 (7,989)	99.3/98.1 (4,700)	92.5/83.6 (2,626)
Moxifloxacin	33.1/32.8 (35,837)	31.9/31.8 (4,435)	25.2/24.9 (16,087)	41.8/41.5 (7,989)	48.7/48.4 (4,700)	29.6/29.4 (2,626)
Oxacilin	0/- (35,837)	0/- (4,435)	0/- (16,087)	0/- (7,989)	0/- (4,700)	0/- (2,626)
Teicoplanin	>99.9/97.3 (35,837)	100/99.4 (4,435)	>99.9/98.1 (16,087)	99.9/93.4 (7,989)	>99.9/98.9 (4,700)	100/98.6 (2,626)
Tigecycline	98.7/98.7 (35,837)	99.5/99.5 (4,435)	99.2/99.2 (16,087)	95.8/95.8 (7,989)	99.9/99.9 (4,700)	99.9/99.9 (2,626)
TMP-SMX	95.5/95.5 (23,918)	96.0/96.0 (2,574)	97.7/97.7 (11,021)	90.5/90.5 (5,195)	98.7/98.7 (3,290)	89.5/89.5 (1,838)
Vancomycin	>99.9/>99.9 (35,837)	>99.9/>99.9 (4,435)	>99.9/>99.9 (16,087)	>99.9/>99.9 (7,989)	100/100 (4,700)	100/100 (2,626)
MSSA
Ceftaroline	>99.9/>99.9 (25,208)	100/100 (2,125)	>99.9/>99.9 (12,375)	99.9/99.9 (4,866)	100/100 (3,771)	100/100 (2,071)
Clindamycin	95.3/94.7 (25,208)	94.0/93.7 (2,125)	96.4/95.7 (12,375)	90.3/89.8 (4,866)	97.0/96.7 (3,771)	98.4/97.7 (2,071)
Daptomycin	99.9/99.9 (25,208)	99.8/99.8 (2,125)	99.8/99.8 (12,375)	99.9/99.9 (4,866)	>99.9/>99.9 (3,771)	100/100 (2,071)
Erythromycin	75.8/79.4 (25,208)	57.1/61.9 (2,125)	79.0/82.6 (12,375)	75.2/78.3 (4,866)	74.6/78.2 (3,771)	79.0/82.6 (2,071)
Gentamicin	95.2/69.3 (16,620)	98.7/61.5 (1,226)	97.3/69.7 (8,167)	90.3/71.3 (3,094)	93.8/69.9 (2,732)	93.2/68.9 (1,401)
Levofloxacin	93.0/93.0 (25,208)	86.3/86.3 (2,125)	93.3/93.3 (12,375)	93.7/93.7 (4,866)	96.5/96.5 (3,771)	90.8/90.8 (2,071)
Linezolid	100/100 (25,208)	100/100 (2,125)	100/100 (12,375)	>99.9/>99.9 (4,866)	100/100 (3,771)	100/100 (2,071)
Minocycline	98.9/96.9 (25,208)	98.4/97.0 (2,125)	98.9/96.9 (12,375)	98.7/96.1 (4,866)	99.5/98.0 (3,771)	98.6/96.7 (2,071)
Moxifloxacin	93.3/92.9 (25,208)	86.5/86.3 (2,125)	93.6/93.1 (12,375)	93.9/93.6 (4,866)	96.7/96.4 (3,771)	90.9/90.6 (2,071)
Oxacilin	100/- (25,208)	100/- (2,125)	100/- (12,375)	100/- (4,866)	100/- (3,771)	100/- (2,071)
Teicoplanin	>99.9/99.6 (25,208)	100/>99.9 (2,125)	>99.9/99.7 (12,375)	100/99.6 (4,866)	100/99.1 (3,771)	>99.9/99.7 (2,071)
Tigecycline	99.5/99.5 (25,208)	99.9/99.9 (2,125)	99.6/99.6 (12,375)	98.7/98.7 (4,866)	>99.9/>99.9 (3,771)	>99.9/>99.9 (2,071)
TMP-SMX	98.4/98.4 (16,620)	98.6/98.6 (1,226)	99.0/99.0 (8,167)	97.1/97.1 (3,094)	99.3/99.3 (2,732)	95.9/95.9 (1,401)
Vancomycin	100/100 (25,208)	100/100 (2,125)	100/100 (12,375)	100/100 (4,866)	100/100 (3,771)	100/100 (2,071)

Abbreviations: CLSI, Clinical and Laboratory Standards Institute; EUCAST, European Committee on Antimicrobial Susceptibility Testing; TMP-SMX, trimethoprim-sulfamethoxazole; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-sensitive Staphylococcus aureus.

Table 4 Distribution Of Ceftaroline MICs For Isolates Of Ceftaroline-Resistant Staphylococcus aureus

Organism (No. Of Isolates Tested)	No. Of Isolates Inhibited At Ceftaroline MIC (mg/L)					MIC (mg/L)
	4	8	16	32	64	MIC50	MIC90
MRSA* (263)	238	22	0	0	3	4	4

Note: *All ceftaroline-resistant isolates were MRSA.

Abbreviations: MIC, minimal inhibitory concentration; MRSA, methicillin-resistant Staphylococcus aureus.

Table 5 Susceptibilities Of Ceftaroline-Resistant MRSA To Comparators

Antimicrobial Agent (No. Of Isolates Tested)	CLSI MIC Interpretation			EUCAST MIC Interpretation
	% Susceptible	% Intermediate	% Resistant	% Susceptible	% Intermediate	% Resistant
Clindamycin (263)	8.0	0.4	91.6	8.0	0	92.0
Daptomycin (263)	98.9	1.1	0	98.9	0	1.1
Erythromycin (263)	1.1	1.9	97.0	1.9	0.4	97.7
Gentamicin (182)	9.3	0.6	90.1	8.8	0	91.2
Levofloxacin (263)	0	0	100	0	0	100
Linezolid (263)	100	0	0	100	0	0
Minocycline (263)	76.4	9.5	14.1	70.3	1.9	27.8
Moxifloxacin (263)	0	0	100	0	0	100
Oxacilin (263)	0	0	100	–	–	–
Teicoplanin (263)	100	0	0	90.1	0	9.9
Tigecycline (263)	94.3	5.7	0	94.3	0	5.7
TMP-SMX (182)	96.7	0	3.3	96.7	1.1	2.2
Vancomycin (263)	100	0	0	100	0	0

Abbreviations: MRSA, methicillin-resistant Staphylococcus aureus; CLSI, Clinical and Laboratory Standards Institute; MIC, minimal inhibitory concentration; EUCAST, European Committee on Antimicrobial Susceptibility Testing; TMP-SMX, trimethoprim sulfamethoxazole.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.