In vitro Activity of Ceftaroline Against Isolates of Gram-Positive Bacteria from Patients with Bloodstream Infections Collected as a Part of ATLAS Between 2017 and 2020

Figures & data

Table 1 Distribution of Gram-Positive Isolates from Blood Collected Globally and Across Different Regions in 2017–2020

Organisms/Region	Global	AfME	APAC	Europe	LATAM	North America
S. aureus (N)	7373	525	1223	3458	1327	840
MRSA [n (% of N)]	2247 (30.5%)	126 (24.0%)	474 (38.8%)	849 (24.6%)	502 (37.8%)	296 (35.2%)
MSSA [n (% of N)]	5126 (69.5%)	399 (76.0%)	749 (61.2%)	2609 (75.4%)	825 (62.2%)	544 (64.8%)
S. pneumoniae (N)	2755	224	336	1591	204	400
PRSP (CLSI) [n (% of N)]	273 (9.9%)	36 (16.1%)	71 (21.1%)	108 (6.8%)	45 (22.1%)	13 (3.3%)
PRSP (EUCAST) [n (% of N)]	112 (4.1%)	12 (5.4%)	24 (7.1%)	50 (3.1%)	22 (10.8%)	4 (1.0%)
PSSP [n (% of N)]	2097 (76.1%)	148 (66.1%)	196 (58.3%)	1310 (82.3%)	103 (50.5%)	340 (85.0%)
S. agalactiae (N)	801	52	145	349	84	171
S. dysgalactiae (N)	316	16	67	140	46	47
S. pyogenes (N)	704	57	101	341	82	123
CoNS (N)^a	4155	473	671	1943	638	430
S. epidermis [n (% of N)]	2326 (56.0%)	210 (44.4%)	332 (49.5%)	1130 (58.2%)	379 (59.4%)	275 (64.0%)
S. haemolyticus [n (% of N)]	1615 (38.9%)	215 (45.5%)	281 (41.9%)	738 (38.0%)	231 (36.2%)	150 (34.9%)

Notes: ^aIncludes isolates of S. capitis (N=57), S. epidermis (N=2326), S. haemolyticus (N=1615), S. hominis (N=130), S. lugdunensis (N=13), S. saprophyticus (N=12), and S. simulans (N=2).

Abbreviations: AfME, Africa and Middle East; APAC, Asia Pacific; LATAM, Latin America; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-susceptible Staphylococcus aureus; N, total number of isolates; n, number of isolate of a particular phenotype; PRSP, penicillin-resistant Streptococcus pneumoniae; PSSP, penicillin-susceptible Streptococcus pneumoniae; CoNS, coagulase-negative staphylococci.

Table 2 Antimicrobial Activity of Ceftaroline and Comparators Against Gram-Positive Isolates from Blood Collected Globally in 2017–2020

Drugs		%S		MIC (mg/L)
	N	CLSI	EUCAST	MIC50	MIC90	MIC Range
S. aureus
Ceftaroline	6867	96.8	96.8	0.25	1	0.015–16
Daptomycin	6867	99.8	99.8	0.5	1	0.06–8
Erythromycin	6867	61.1	63.4	0.5	8	0.12–16
Levofloxacin^a	7373	76.4	76.4	0.25	8	0.03–64
Linezolid	7373	100.0	100.0	2	2	0.5–16
Minocycline	1414	96.4	93.4	0.25	0.5	0.12–16
Tigecycline^b	7373	99.7	99.7	0.12	0.12	0.015–2
TMP-SMX	6867	98.0	98.0	0.06	0.25	0.03–8
Vancomycin	7373	100.0	100.0	1	1	0.25–2
MRSA
Ceftaroline	2097	89.8	89.8	0.5	2	0.015–16
Daptomycin	2097	99.5	99.5	0.5	1	0.12–8
Erythromycin	2097	33.6	34.7	8	16	0.12–16
Levofloxacin^a	2217	37.9	37.9	8	8	0.03–64
Linezolid	2217	100.0	100.0	2	2	0.5–4
Minocycline	600	92.8	87.2	0.12	2	0.12–16
Tigecycline^b	2217	99.0	99.0	0.12	0.25	0.015–2
TMP-SMX	2097	95.6	95.6	0.12	0.5	0.03–8
Vancomycin	2217	100.0	100.0	1	1	0.25–2
MSSA
Ceftaroline	4685	100.0	100.0	0.25	0.25	0.015–4
Daptomycin	4685	99.9	99.9	0.5	0.5	0.06–8
Erythromycin	4685	73.7	76.6	0.5	8	0.12–16
Levofloxacin^a	5071	93.1	93.1	0.25	0.5	0.03–64
Linezolid	5071	100.0	100.0	2	2	0.5–16
Minocycline	814	99.0	98.0	0.25	0.25	0.12–16
Tigecycline^b	5071	99.9	99.9	0.06	0.12	0.015–1
TMP-SMX	4685	99.1	99.1	0.06	0.25	0.03–8
Vancomycin	5071	100.0	100.0	1	1	0.25–2
S. pneumoniae
Ceftaroline	2445	99.9	99.6	0.008	0.12	0.004–1
Ceftriaxone	2755	96.4	90.3	0.03	0.5	0.015–8
Erythromycin	2751	76.9	76.9	0.03	2	0.008–128
Levofloxacin^a	2755	99.5	99.5	1	1	0.06–16
Linezolid	2755	100.0	100.0	1	1	0.06–2
Minocycline	801	82.3	77.3	0.25	4	0.015–16
Tigecycline^b	2755	99.8	NA	0.03	0.03	0.008–0.5
Vancomycin	2755	100.0	100.0	0.25	0.5	0.008–1
S. agalactiae
Ceftaroline^c	662	100.0	NA	0.015	0.015	0.004–0.06
Ceftriaxone^c	801	99.9	NA	0.06	0.12	0.015–1
Daptomycin	28	100.0	100.0	0.25	0.5	0.12–0.5
Erythromycin	662	61.8	61.8	0.06	2	0.015–2
Levofloxacin^a	801	94.5	94.5	1	2	0.06–64
Linezolid	801	100.0	100.0	1	2	0.5–2
Minocycline	167	24.0	19.8	8	8	0.06–16
Tigecycline^b	801	99.9	99.8	0.03	0.06	0.008–1
Vancomycin	801	100.0	100.0	0.5	0.5	0.03–1
S. dysgalactiae
Ceftaroline^c	316	100.0	NA	0.008	0.015	0.004–0.06
Ceftriaxone^c	316	100.0	NA	0.03	0.06	0.015–0.5
Daptomycin	53	100.0	100.0	0.06	0.25	0.06–0.25
Erythromycin	316	73.4	73.4	0.06	2	0.03–2
Levofloxacin^a	316	97.2	97.2	0.5	1	0.12–16
Linezolid	316	100.0	100.0	1	2	0.25–2
Minocycline	53	66.0	64.2	0.12	4	0.25–8
Tigecycline^b	316	99.7	95.9	0.06	0.12	0.015–0.5
Vancomycin	316	100.0	100.0	0.25	0.5	0.015–1
S. pyogenes
Ceftaroline^c	690	100.0	NA	0.004	0.008	0.004–0.06
Ceftriaxone^c	704	100.0	NA	0.03	0.03	0.015–0.12
Daptomycin	146	100.0	100.0	0.06	0.12	0.03–0.5
Erythromycin	690	88.3	88.3	0.03	2	0.015–2
Levofloxacin^a	704	99.3	99.3	0.5	1	0.12–8
Linezolid	704	100.0	100.0	1	1	0.12–2
Minocycline	160	83.1	78.1	0.06	4	0.03–4
Tigecycline^b	704	100.0	100.0	0.03	0.06	0.008–0.12
Vancomycin	704	100.0	100.0	0.5	0.5	0.03–1
CoNS^d
Amoxy/clav	767	NA	NA	2	16	0.03–16
Ceftaroline	4006	NA	NA	0.5	2	0.015–32
Ceftriaxone	767	NA	NA	16	64	0.03–128
Daptomycin	4006	99.8	99.8	0.5	1	0.06–8
Erythromycin	4006	24.7	24.9	8	16	0.12–16
Levofloxacin^a	4155	34.9	34.9	4	8	0.015–64
Linezolid	4155	98.7	98.7	1	2	0.5–16
Minocycline	766	99.9	96.7	0.25	0.5	0.12–16
Pip/taz	767	NA	NA	2	32	0.03–32
Tigecycline^b	4154	99.2	99.2	0.12	0.25	0.015–2
TMP-SMX	4006	53.0	53.0	2	4	0.03–8
Vancomycin	4155	100.0	100.0	2	2	0.12–32
Staphylococcus epidermis
Amoxy/clav	464	NA	NA	2	16	0.03–16
Ceftaroline	2240	NA	NA	0.25	1	0.015–32
Ceftriaxone	464	NA	NA	16	64	0.03–128
Daptomycin	2240	99.8	99.8	0.5	1	0.06–8
Erythromycin	2240	31.7	31.9	8	16	0.12–16
Levofloxacin^a	2326	42	42	4	8	0.03–64
Linezolid	2326	97.9	97.9	1	2	0.5–16
Minocycline	464	100.0	97.0	0.25	0.5	0.12–4
Pip/taz	464	NA	NA	1	32	0.12–32
Tigecycline^b	2326	99.4	99.4	0.12	0.25	0.015–2
TMP-SMX	2240	57.1	57.1	2	4	0.03–8
Vancomycin	2326	99.9	99.9	2	2	0.12–32
Staphylococcus haemolyticus
Amoxy/clav	138	NA	NA	16	16	0.03–16
Ceftaroline	1552	NA	NA	2	2	0.06–8
Ceftriaxone	138	NA	NA	64	128	0.03–128
Daptomycin	1552	99.9	99.9	0.25	0.5	0.06–2
Erythromycin	1552	12.7	12.8	8	8	0.12–16
Levofloxacin^a	1615	21.6	21.6	8	8	0.03–64
Linezolid	1615	99.8	99.8	1	2	0.5–16
Minocycline	137	100.0	97.8	0.25	0.5	0.12–4
Pip/taz	138	NA	NA	32	32	0.03–32
Tigecycline^b	1614	98.9	98.9	0.12	0.25	0.015–2
TMP-SMX	1552	45.6	45.6	4	4	0.06–8
Vancomycin	1615	100	100	1	2	0.12–4

Notes: ^aSusceptible, increased exposure for EUCAST breakpoints. ^bData for tigecycline was interpreted using FDA approved breakpoints. ^cEUCAST has not published breakpoints for ceftaroline, and ceftriaxone tested against β-haemolytic streptococci; EUCAST states that susceptibility to these agents can be inferred from testing benzyl penicillin. ^dIncludes isolates of S. capitis (N=57), S. epidermis (N=2326), S. haemolyticus (N=1615), S. hominis (N=130), S. lugdunensis (N=13), S. saprophyticus (N=12), and S. simulans (N=2).

Abbreviations: Amoxy/clav, amoxicillin clavulanate; CoNS, coagulase-negative staphylococci; MIC, minimum inhibitory concentration; MIC₅₀ minimum inhibitory concentration required to inhibit 50% of the organisms; MIC₉₀ minimum inhibitory concentration required to inhibit 90% of the organisms; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-susceptible Staphylococcus aureus; N, total number of isolates; NA, not available; S, susceptible; TMP-SMX, trimethoprim-sulfamethoxazole.

Table 3 Antimicrobial Activity of Ceftaroline and Comparators Against PRSP and PSSP Isolates from Blood Collected Globally in 2017–2020

	CLSI					EUCAST
	N	%S	MIC50 (mg/L)	MIC90 (mg/L)	MIC range (mg/L)	N	%S	MIC50 (mg/L)	MIC90 (mg/L)	MIC range (mg/L)
PRSP
Ceftaroline	246	99.2	0.12	0.25	0.03–1	104	91.4	0.25	0.25	0.06–1
Ceftriaxone	273	65.9	1	2	0.03–8	112	5.4	2	4	0.03–8
Erythromycin	273	18.7	2	2	0.015–128	112	17.0	2	2	0.015–128
Levofloxacin^a	273	97.1	1	2	0.25–16	112	95.5	1	2	0.25–16
Linezolid	273	100.0	1	1	0.12–2	112	100.0	0.5	1	0.12–2
Minocycline	80	42.5	4	4	0.06–16	23	34.8	4	4	0.06–16
Tigecycline^b	273	98.5	0.03	0.03	0.008–0.5	112	NA	0.03	0.03	0.008–0.06
Vancomycin	273	100.0	0.5	0.5	0.12–1	112	100.0	0.5	0.5	0.25–1
PSSP
Ceftaroline	1876	100.0	0.008	0.015	0.004–0.25	1876	100.0	0.008	0.015	0.004–0.25
Ceftriaxone	2097	100.0	0.03	0.06	0.015–1	2097	99.9	0.03	0.06	0.015–1
Erythromycin	2094	89.2	0.03	2	0.008–128	2094	89.2	0.03	2	0.008–128
Levofloxacin^a	2097	99.9	1	1	0.06–8	2097	99.9	1	1	0.06–8
Linezolid	2097	100.0	1	1	0.06–2	2097	100.0	1	1	0.06–2
Minocycline	593	91.7	0.06	1	0.015–8	593	86.7	0.06	1	0.015–8
Tigecycline^b	2097	100.0	0.03	0.03	0.008–0.5	2097	NA	0.03	0.03	0.008–0.5
Vancomycin	2097	100.0	0.25	0.5	0.008–1	2097	100.0	0.25	0.5	0.008–1

Notes: ^aSusceptible, increased exposure for EUCAST breakpoints. ^bData for tigecycline was interpreted using FDA approved breakpoint.

Abbreviations: MIC, minimum inhibitory concentration; MIC₅₀ minimum inhibitory concentration required to inhibit 50% of the organisms; MIC₉₀ minimum inhibitory concentration required to inhibit 90% of the organisms; N, total number of isolates; PRSP, penicillin-resistant Streptococcus pneumoniae; PSSP, penicillin-susceptible Streptococcus pneumoniae.