LAUSR

OBJECTIVES To report antimicrobial susceptibility testing surveillance data for ceftaroline and comparative agents from the AWARE global surveillance program for bacterial pathogens causing SSTIs and lower RTIs in Middle East and African countries from 2015 to 2018. METHODS Pathogens were identified by MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed using the CLSI broth microdilution method. MICs were interpreted by both CLSI (M100, 2020) and EUCAST (v 10.0, 2020) breakpoints. RESULTS All MSSA (n = 1,125) and 93.9% of MRSA (n = 1,235) were susceptible to ceftaroline (MIC ≤ 1 µg/mL, CLSI and EUCAST). The maximum ceftaroline MIC observed for MRSA was 2 µg/mL; no ceftaroline-resistant MRSA were identified among SSTI (CLSI and EUCAST) and RTI (CLSI) isolates. All isolates of β-hemolytic Streptococcus (n = 324), and penicillin-susceptible (PSSP) and -intermediate Streptococcus pneumoniae (PISP; n = 369) were susceptible to ceftaroline. Rates of susceptibility to ceftaroline for penicillin-resistant S. pneumoniae (penicillin MIC ≥ 2 µg/mL; n = 175), and β-lactamase-negative (BLNHI; n = 224) and β-lactamase-positive Haemophilus influenzae (n = 49) were 99.4%, 98.7%, and 98.0% (CLSI) and 92.6%, 98.2%, and 83.7% (EUCAST), respectively. Rates of susceptibility to ceftaroline for ESBL-negative Escherichia coli (n = 442), Klebsiella pneumoniae (n = 381), and Klebsiella oxytoca (n = 103) were 92.1%, 93.2%, and 96.1%, respectively. CONCLUSION Ceftaroline-resistant isolates of MRSA causing SSTIs were not identified in Middle East and African countries in 2015-2018 using recently revised CLSI (in 2019) or EUCAST (in 2018) breakpoint criteria. Common bacterial pathogens causing SSTIs (Staphylococcus aureus, β-hemolytic Streptococcus) and lower RTIs (PSSP, PISP, BLNHI) demonstrated no resistance or low levels of resistance (0-1.8%) to ceftaroline.