Omadacycline is a derivative of minocycline and the first agent of the aminomethylcycline class. A total of 3,282 organisms (one per patient) were consecutively collected from patients hospitalized in China (including Hong Kong) and Taiwan. Susceptibility testing was performed by broth microdilution methods in a central laboratory (JMI Laboratories). The collection included Gram-positive and Gram-negative organisms from patients with pneumonia, bloodstream, skin, community-acquired respiratory, and other infections. Omadacycline was very potent against Staphylococcus aureus (n=689; MIC50/90, 0.12/0.25 mg/L), including methicillin-resistant isolates (MRSA; n=299; MIC50/90, 0.12/0.5 mg/L), and had similar activity across geographic regions. Omadacycline was very active against Streptococcus pneumoniae (highest MIC, 0.25 mg/L), β-hemolytic streptococci (highest MIC, 1 mg/L), viridans group streptococci (highest MIC, 0.25 mg/L), and Enterococcus spp. (highest MIC, 0.5 mg/L) from all geographic regions. Overall, 53.8% of S. pneumoniae were penicillin-resistant (PRSPN; penicillin MIC, ≥2 mg/L) and 10.7% of enterococci (21.2% among E. faecium) were vancomycin-resistant (VRE). Omadacycline was active against Haemophilus influenzae (MIC50/90, 0.5/1 mg/L) regardless of β-lactamase production and was active against Moraxella catarrhalis (MIC50/90, ≤0.12/0.25 mg/L). Against Enterobacteriaceae, omadacycline was most active against Escherichia coli (MIC50/90, 1/2 mg/L), Klebsiella oxytoca (MIC50/90, 1/4 mg/L), and Enterobacter cloacae (MIC50/90, 2/4 mg/L). Omadacycline showed potent in vitro activity against Gram-positive and Gram-negative pathogens isolated from China and Taiwan, and retained activity against problem pathogens, such as MRSA, VRE, PRSPN, and extended-spectrum β-lactamase-producing E. coli. The observed MIC profile in Chinese isolates was very similar to that seen in the US and European surveillance studies.
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