ANTIMICROBIAL ACTIVITY OF CEFTAROLINE AGAINST STAPHYLOCOCCUS AUREUS ISOLATED FROM PATIENTS WITH INFECTIVE ENDOCARDITIS WORLDWIDE (2010-2019)

Abstract

SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Ceftaroline is approved by the United States (US) Food and Drug Administration for community-acquired bacterial pneumonia and skin and skin-structure infections, including cases with concurrent bacteremia, and has demonstrated efficacy in cases of infective endocarditis (IE). We evaluated the antimicrobial activity of ceftaroline against S. aureus isolated from patients with IE. METHODS: 23,834 S. aureus isolates were collected consecutively from patients with bloodstream infections (BSI) from 2010 to 2019 via the SENTRY Antimicrobial Surveillance Program, including 396 isolates patients with a diagnosis of IE. IE isolates were collected from 19 medical centers in the US (n=124), 34 in Europe (EUR; n=213), and 22 in other geographic regions (n=59) and were tested for susceptibility against ceftaroline and comparators by reference broth microdilution method in a monitoring laboratory (JMI Laboratories). RESULTS: Among IE isolates, the overall oxacillin resistance (MRSA) rate was 29.0%, but this rate was higher in the US (40.3%) than EUR (25.4%) and other regions (18.6%). Ceftaroline was active against 95.2% of IE isolates (MIC50/90, 0.25/1 mg/L) and ceftaroline susceptibility was higher in the US (99.2%) and other regions (98.3%) than EUR (92.0%). Among oxacillin-susceptible (MSSA) isolates, the highest ceftaroline MIC value was 0.5 mg/L (94.7% inhibited at ≤0.25 mg/L). Among MRSA isolates from IE (n=115; MIC50/90, 1/2 mg/L), ceftaroline susceptibility was 98.0% in the US and 68.5% in EUR (90.9% in other regions; n=11). The highest ceftaroline MIC was only 2 mg/L and all ceftaroline-nonsusceptible isolates were categorized as susceptible dose dependent or intermediate (0.0% resistant). Dalbavancin (MIC50/90, ≤0.03/0.06 mg/L), daptomycin (MIC50/90, 0.25/0.5 mg/L), linezolid (MIC50/90, 1/2 mg/L), teicoplanin (MIC50/90, ≤2/≤2 mg/L), tigecycline (MIC50/90, 0.06/0.12 mg/L), and vancomycin (MIC50/90, 1/1 mg/L) exhibited complete activity (100.0% susceptible) against S. aureus from IE. Among all BSI S. aureus isolates (n=23,834), MRSA rates were 43.6% in the US and 25.6% in EUR, and ceftaroline susceptibility rates were 98.1% in the US and 95.4% in EUR. CONCLUSIONS: Ceftaroline exhibited potent in vitro activity against a large collection of S. aureus isolates recovered from patients with IE. Ceftaroline was particularly active against MRSA-causing BSI and IE in US medical centers. These results support further investigations to determine the role of ceftaroline in the treatment of IE. CLINICAL IMPLICATIONS: These results support further investigations to determine the role of ceftaroline in the treatment of IE. DISCLOSURES: No relevant relationships by Cecilia Carvalhaes, source=Web Response no disclosure on file for Rodrigo Mendes; Research Contractor relationship with Allergan Please note: $1001 - $5000 Added 03/11/2020 by Helio Sader, source=Web Response, value=Grant/Research Support no disclosure on file for Streit Streit