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Background Ceftaroline, the active metabolite of ceftaroline fosamil, is a cephalosporin developed for treating infections caused by Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA), Streptococcus pneumoniae, β-hemolytic streptococci, and some Gram-negative pathogens. This study reports the in vitro activity of ceftaroline against clinically relevant isolates collected in 2016 from the AWARE Surveillance Program. Methods 22,752 non-duplicate methicillin-sensitive S. aureus (MSSA), MRSA, S. pneumoniae, β-hemolytic streptococci (S. pyogenes, S. agalactiae, S. dysgalactiae) Haemophilus influenzae, and extended spectrum β-lactamase (ESBL)-negative Enterobacteriaceae were collected from (n/%) Asia/South Pacific (4,215/18.5%), Europe (12,962/57.0%), Latin America (3,384/14.9%), and Middle East/Africa (2,191/9.6%) during 2016. Isolates were from (n/%) complicated intraabdominal (2,149/9.5%), complicated urinary tract (3,029/13.3%), complicated skin and skin structure (8,271/36.4%), blood stream (2,422/10.6%) and lower respiratory tract infections (6,881/30.2%). MIC values were determined by broth microdilution and interpreted using CLSI breakpoints. Results Ceftaroline activity, based on % susceptibility (%S) and MIC90, is shown in the table. Ceftaroline was active in vitro against both Gram-positive (100% of MSSA, 93.6% of MRSA and 99.7% of S. pneumoniae) and Gram-negative (99.7% of H. influenzae and 91.7% of ESBL-negative Enterobacteriaceae) isolates. Organism (N) % S % I % R MIC 50 MIC 90 MRSA (5,022) 93.6 6.0 0.5 0.5 1 MSSA (3,675) 100 0 0 0.25 0.25 Streptococcus pneumoniae (2,024) 99.7 -- 0.3 0.008 0.12 β-hemolytic streptococci (1,713) 100 -- -- 0.008 0.015 Enterobacteriaceae, ESBL-Negative (9,647) 91.7 3.7 4.6 0.12 0.5 Haemophilus influenzae (671) 99.7 -- 0.3 ≤0.015 0.03 %S, %I, %R- percent susceptible, intermediate, resistant based on CLSI breakpoints; MIC50, MIC90 in µg/mL. Conclusion Based on these data generated with isolates collected in 2016, ceftaroline exhibited potent in vitro activity against clinically relevant isolates, with >91% of all isolates susceptible at their CLSI breakpoints. Funding: This study was sponsored by AstraZeneca. The AstraZeneca product ceftaroline fosamil was acquired by Pfizer in December 2016. Disclosures J. Iaconis, AstraZeneca: Employee and Shareholder, Salary and Shareholder in AstraZeneca

In vitro Activity of Ceftaroline Against Pathogens Collected Globally from the AWARE Surveillance Program, 2016