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Background  The IDEA Program monitors the  in vitro  activity of dalbavancin and comparators against Gram-positive (GP) bacteria causing bloodstream infections (BSIs) and other infections in the United States (US) and Europe (EU). We evaluated the BSI results in 2018-2020.    Methods  8,643 organisms were consecutively collected (1/patient) from 74 medical centers located in the US (n=4,544; 33 centers), western EU (W-EU; n=3,330; 28 centers from 10 nations: Belgium, France, Germany, Ireland, Italy, Portugal, Spain, Sweden, Switzerland, and the United Kingdom), and eastern EU (E-EU; n=769; 13 centers from 10 nations: Belarus, Czech Republic, Greece, Hungary, Israel, Poland, Romania, Russia, Slovenia, and Turkey). Organisms were susceptibility tested by reference broth microdilution methods in a central laboratory.Results  Overall, the most common GP organisms were  S. aureus  (SA; 45.2%),  E. faecalis  (EF; 12.2%),  S. epidermidis  (SEP; 8.9%), β-hemolytic streptococci (BHS; 8.5%), and  E. faecium  (EFM; 7.6%), but rank order varied markedly by geographic region. The top 3 GP organisms were SA, EF, and BHS in the US; SA, EF, and EFM in W-EU; and SA,  S. pneumoniae , and BHS in E-EU. Dalbavancin was highly active against methicillin-susceptible (MSSA) and -resistant (MRSA) SA, with an MIC 90  of 0.03 mg/L in all 3 regions (Table). Among SA, MRSA rates were higher in the US (41.3%) than W-EU (21.5%) or E-EU (27.3%), and ceftaroline susceptibility ranged from 95.4% (W-EU) to 96.6% (US). Vancomycin (VAN) susceptibility varied from 97.3% (E-EU) to 98.3% (W-EU) among EF (97.5% in US), and dalbavancin was active against all VAN-S EF (MIC 50/90 , 0.03/0.06 mg/L; 100.0%S). Among SEP, all isolates were inhibited at ≤0.25 mg/L of dalbavancin (MIC 50/90 , 0.03/0.06 mg/L) and oxacillin resistance ranged from 66.9% in W-EU to 86.5% in E-EU (73.2% in US). BHS exhibited low dalbavancin MIC values (MIC 50/90 , 0.015/0.03 mg/L) and high S rates for its comparators. Among EFM, VAN-S rates varied from 36.6% in the US to 61.6% in E-EU and 76.1% in W-EU, and dalbavancin inhibited all VAN-S EFM at ≤0.25 mg/L (MIC 50/90 , 0.03/0.12 mg/L).    Conclusion  Dalbavancin exhibited potent activity and broad spectrum against a large collection of contemporary GP bacteria recovered from patients with BSI in US and EU.Disclosures    Helio S. Sader, MD, PhD, FIDSA ,  AbbVie (formerly Allergan ) (Research Grant or Support) Basilea Pharmaceutica International, Ltd.  (Research Grant or Support) Cipla Therapeutics  (Research Grant or Support) Cipla USA Inc.  (Research Grant or Support) Department of Health and Human Services  (Research Grant or Support, Contract no. HHSO100201600002C) Melinta Therapeutics, LLC  (Research Grant or Support) Nabriva Therapeutics  (Research Grant or Support) Pfizer, Inc.  (Research Grant or Support) Shionogi  (Research Grant or Support) Spero Therapeutics  (Research Grant or Support)  Mariana Castanheira, PhD ,  AbbVie (formerly Allergan ) (Research Grant or Support) Bravos Biosciences  (Research Grant or Support) Cidara Therapeutics, Inc.  (Research Grant or Support) Cipla Therapeutics  (Research Grant or Support) Cipla USA Inc.  (Research Grant or Support) GlaxoSmithKline  (Research Grant or Support) Melinta Therapeutics, Inc.  (Research Grant or Support) Melinta Therapeutics, LLC  (Research Grant or Support) Pfizer, Inc.  (Research Grant or Support) Qpex Biopharma  (Research Grant or Support) Shionogi  (Research Grant or Support) Spero Therapeutics  (Research Grant or Support)  Mariana Castanheira, PhD , Affinity Biosensors (Individual(s) Involved: Self): Research Grant or Support; Allergan (Individual(s) Involved: Self): Research Grant or Support; Amicrobe, Inc (Individual(s) Involved: Self): Research Grant or Support; Amplyx Pharma (Individual(s) Involved: Self): Research Grant or Support; Artugen Therapeutics USA, Inc. (Individual(s) Involved: Self): Research Grant or Support; Astellas (Individual(s) Involved: Self): Research Grant or Support; Basilea (Individual(s) Involved: Self): Research Grant or Support; Beth Israel Deaconess Medical Center (Individual(s) Involved: Self): Research Grant or Support; BIDMC (Individual(s) Involved: Self): Research Grant or Support; bioMerieux Inc. (Individual(s) Involved: Self): Research Grant or Support; BioVersys Ag (Individual(s) Involved: Self): Research Grant or Support; Bugworks (Individual(s) Involved: Self): Research Grant or Support; Cidara (Individual(s) Involved: Self): Research Grant or Support; Cipla (Individual(s) Involved: Self): Research Grant or Support; Contrafect (Individual(s) Involved: Self): Research Grant or Support; Cormedix (Individual(s) Involved: Self): Research Grant or Support; Crestone, Inc. (Individual(s) Involved: Self): Research Grant or Support; Curza (Individual(s) Involved: Self): Research Grant or Support; CXC7 (Individual(s) Involved: Self): Research Grant or Support; Entasis (Individual(s) Involved: Self): Research Grant or Support; Fedora Pharmaceutical (Individual(s) Involved: Self): Research Grant or Support; Fimbrion Therapeutics (Individual(s) Involved: Self): Research Grant or Support; Fox Chase (Individual(s) Involved: Self): Research Grant or Support; GlaxoSmithKline (Individual(s) Involved: Self): Research Grant or Support; Guardian Therapeutics (Individual(s) Involved: Self): Research Grant or Support; Hardy Diagnostics (Individual(s) Involved: Self): Research Grant or Support; IHMA (Individual(s) Involved: Self): Research Grant or Support; Janssen Research & Development (Individual(s) Involved: Self): Research Grant or Support; Johnson & Johnson (Individual(s) Involved: Self): Research Grant or Support; Kaleido Biosceinces (Individual(s) Involved: Self): Research Grant or Support; KBP Biosciences (Individual(s) Involved: Self): Research Grant or Support; Luminex (Individual(s) Involved: Self): Research Grant or Support; Matrivax (Individual(s) Involved: Self): Research Grant or Support; Mayo Clinic (Individual(s) Involved: Self): Research Grant or Support; Medpace (Individual(s) Involved: Self): Research Grant or Support; Meiji Seika Pharma Co., Ltd. (Individual(s) Involved: Self): Research Grant or Support; Melinta (Individual(s) Involved: Self): Research Grant or Support; Menarini (Individual(s) Involved: Self): Research Grant or Support; Merck (Individual(s) Involved: Self): Research Grant or Support; Meridian Bioscience Inc. (Individual(s) Involved: Self): Research Grant or Support; Micromyx (Individual(s) Involved: Self): Research Grant or Support; MicuRx (Individual(s) Involved: Self): Research Grant or Support; N8 Medical (Individual(s) Involved: Self): Research Grant or Support; Nabriva (Individual(s) Involved: Self): Research Grant or Support; National Institutes of Health (Individual(s) Involved: Self): Research Grant or Support; National University of Singapore (Individual(s) Involved: Self): Research Grant or Support; North Bristol NHS Trust (Individual(s) Involved: Self): Research Grant or Support; Novome Biotechnologies (Individual(s) Involved: Self): Research Grant or Support; Paratek (Individual(s) Involved: Self): Research Grant or Support; Pfizer (Individual(s) Involved: Self): Research Grant or Support; Prokaryotics Inc. (Individual(s) Involved: Self): Research Grant or Support; QPEX Biopharma (Individual(s) Involved: Self): Research Grant or Support; Rhode Island Hospital (Individual(s) Involved: Self): Research Grant or Support; RIHML (Individual(s) Involved: Self): Research Grant or Support; Roche (Individual(s) Involved: Self): Research Grant or Support; Roivant (Individual(s) Involved: Self): Research Grant or Support; Salvat (Individual(s) Involved: Self): Research Grant or Support; Scynexis (Individual(s) Involved: Self): Research Grant or Support; SeLux Diagnostics (Individual(s) Involved: Self): Research Grant or Support; Shionogi (Individual(s) Involved: Self): Research Grant or Support; Specific Diagnostics (Individual(s) Involved: Self): Research Grant or Support; Spero (Individual(s) Involved: Self): Research Grant or Support; SuperTrans Medical LT (Individual(s) Involved: Self): Research Grant or Support; T2 Biosystems (Individual(s) Involved: Self): Research Grant or Support; The University of Queensland (Individual(s) Involved: Self): Research Grant or Support; Thermo Fisher Scientific (Individual(s) Involved: Self): Research Grant or Support; Tufts Medical Center (Individual(s) Involved: Self): Research Grant or Support; Universite de Sherbrooke (Individual(s) Involved: Self): Research Grant or Support; University of Iowa (Individual(s) Involved: Self): Research Grant or Support; University of Iowa Hospitals and Clinics (Individual(s) Involved: Self): Research Grant or Support; University of Wisconsin (Individual(s) Involved: Self): Research Grant or Support; UNT System College of Pharmacy (Individual(s) Involved: Self): Research Grant or Support; URMC (Individual(s) Involved: Self): Research Grant or Support; UT Southwestern (Individual(s) Involved: Self): Research Grant or Support; VenatoRx (Individual(s) Involved: Self): Research Grant or Support; Viosera Therapeutics (Individual(s) Involved: Self): Research Grant or Support; Wayne State University (Individual(s) Involved: Self): Research Grant or Support  Michael D. Huband, BS ,  AbbVie (formerly Allergan ) (Research Grant or Support) Melinta Therapeutics, LLC  (Research Grant or Support)  Dee Shortridge, PhD ,  AbbVie (formerly Allergan ) (Research Grant or Support) Melinta Therapeutics, Inc.  (Research Grant or Support) Melinta Therapeutics, LLC  (Research Grant or Support) Shionogi  (Research Grant or Support)  Cecilia G. Carvalhaes, MD, PhD ,  AbbVie (formerly Allergan ) (Research Grant or Support) Cidara Therapeutics, Inc.  (Research Grant or Support) Cipla Therapeutics  (Research Grant or Support) Cipla USA Inc.  (Research Grant or Support) Melinta Therapeutics, LLC  (Research Grant or Support) Pfizer, Inc.  (Research Grant or Support)  Rodrigo E. Mendes, PhD ,  AbbVie  (Research Grant or Support) AbbVie (formerly Allergan ) (Research Grant or Support) Cipla Therapeutics  (Research Grant or Support) Cipla USA Inc.  (Research Grant or Support) ContraFect Corporation  (Research Grant or Support) GlaxoSmithKline, LLC  (Research Grant or Support) Melinta Therapeutics, Inc.  (Research Grant or Support) Melinta Therapeutics, LLC  (Research Grant or Support) Nabriva Therapeutics  (Research Grant or Support) Pfizer, Inc.  (Research Grant or Support) Shionogi  (Research Grant or Support) Spero Therapeutics  (Research Grant or Support)

open forum infectious diseases

217. Antimicrobial Activity of Dalbavancin against Gram-Positive Bacteria Isolated from Patients Hospitalized with Bacteremia in United States and European Medical Centers: Results from the International Dalbavancin Evaluation of Activity (IDEA) Program (2018-202)