Global trends of antimicrobial susceptibility of ceftaroline and ceftazidime-avibactam: a surveillance study from the ATLAS program (2012-2016)

Abstract

Background Antibiotic resistance is a global health threat.This study reported the global trends of antimicrobial susceptibility ofceftaroline and ceftazidime-avibactam using data from the Antimicrobial Testing Leadership And Surveillance (ATLAS)programbetween2012and2016. Methods Theminimum inhibitory concentrations (MICs) and in vitro susceptibilities of ceftarolineandceftazidime-avibactam were assessed using the Clinical andLaboratory Standards Institute (CLSI) guidelines. Results Between 2012 and 2016, a total of 176,345 isolates were collected globally and included for analysis.Regarding Gram-negative bacteria, ceftazidime-avibactam demonstrated high susceptibility (>90%) against Enterobacteriaceae and Pseudomonas aeruginosa, with increasedantimicrobial activity observed from the addition of avibactam (4 mg/L) to ceftazidime.Regarding Gram-positive bacteria, ceftaroline showed >90% susceptibility against Staphylococcus aureus , Streptococcus pneumoniae , α-and β-hemolytic Streptococcus .The antimicrobial susceptibility of ceftaroline and ceftazidime-avibactam were mostly stable from 2012 to 2016. Nevertheless, the susceptibility ofceftazidime-avibactam to carbapenem-resistant Klebsiella pneumoniae (CRKPN, 88.4% to 81.6%) and to CR- Pseudomonas aeruginosa (CRPAE, 89.6% to 72.7%) decreased. In terms of regional difference, susceptibilities of MRSA to ceftaroline in Asia and of CRKPN to ceftazidime-avibactam in Asia/Africa-Middle East were loweras compared with other regions whereas the susceptibility of CRPAE to ceftazidime-avibactam in North America was higher. Conclusion The addition of avibactam improved the activity of ceftazidime against Enterobacteriaceae and Pseudomonas aeruginosa. The global antimicrobial susceptibilities of ceftaroline and ceftazidime-avibactam were in general stable from 2012 to 2016, but a marked reduction in the susceptibility of CRPAEtoceftazidime-avibactam was observed.