European Committee on Antimicrobial Susceptibility Testing

Recommendations

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Enterobacteriaceae EUCAST Clinical Breakpoint Tables v. 7.0, valid from 2017-01-01 Macrolides, lincosamides and streptogramins MIC breakpoint (mg/L) Disk content Zone diameter breakpoint (µg) (mm) S ≤ R > S ≥ R < Azithromycin 1 - - - - Clarithromycin - - - - Erythromycin - - - - Roxithromycin - - - - Telithromycin - - - - Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1. Azithromycin has been used in the treatment of infections with Salmonella Typhi (MIC ≤16 mg/L for wild type isolates) and Shigella spp. Clindamycin - - - - Quinupristin-dalfopristin - - - - Tetracyclines MIC breakpoint (mg/L) Disk content Zone diameter breakpoint (µg) (mm) S ≤ R > S ≥ R < Doxycycline - - - - Minocycline - - - - Tetracycline - - - - Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1. Tigecycline has poor activity against Morganella spp., Proteus spp. and Providencia spp. 2. For tigecycline broth microdilution MIC determination, the medium must be prepared fresh on the day of use. A. Zone diameter breakpoints validated for E. coli only. For other Enterobacteriaceae, use an MIC method. Tigecycline 1 1 2 2 2 15 18 A 15 A A. Zone diameter breakpoints validated for E. coli only. For other Enterobacteriaceae, use an MIC method. Oxazolidinones MIC breakpoint (mg/L) Disk content Zone diameter breakpoint (µg) (mm) S ≤ R > S ≥ R < Linezolid - - - - Tedizolid - - - - Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 9
Enterobacteriaceae EUCAST Clinical Breakpoint Tables v. 7.0, valid from 2017-01-01 Miscellaneous agents (µg) (mm) S ≤ R > S ≥ R < Chloramphenicol 8 8 30 17 17 Colistin 1 2 2 Note A Note A Daptomycin - - - - Fosfomycin iv 32 2 32 2 200 B 24 C,D 24 C,D Fosfomycin oral (uncomplicated UTI only) 32 2 32 2 200 B 24 C,D 24 C,D Fusidic acid - - - - Metronidazole - - - - Mupirocin MIC breakpoint (mg/L) Disk content Zone diameter breakpoint Nitrofurantoin (uncomplicated UTI only), E. coli 64 64 100 11 11 Nitroxoline (uncomplicated UTI only), E. coli 16 16 30 15 15 Rifampicin - - - - Spectinomycin - - - - Trimethoprim (uncomplicated UTI only) 2 4 5 18 15 Trimethoprim-sulfamethoxazole 3 2 4 1.25-23.75 14 11 Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1. Quality control of colistin must be performed with both a susceptible QC strain (E. coli ATCC 25922 or P. aeruginosa ATCC 27853) and the colistin resistant E. coli NCTC 13846 (mcr-1 positive). 2. Agar dilution is the reference method for fosfomycin. MICs must be determined in the presence of glucose-6-phosphate (25 mg/L in the medium). Follow the manufacturers' instructions for commercial systems. 3. Trimethoprim:sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration. A. Use an MIC method. B. Fosfomycin 200 µg disks must contain 50 µg glucose-6-phosphate. C. Zone diameter breakpoints apply to E. coli only. For other Enterobacteriaceae, use an MIC method. D. Ignore isolated colonies within the inhibition zone (see pictures below). a) b) c) d) No zone Examples of inhibition zones for Escherichia coli with fosfomycin. a-c) Ignore all colonies and read the outer zone edge. d) Record as no inhibition zone. 10
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Page 3 and 4: Guidance on reading EUCAST Breakpoi
Page 5 and 6: Version 7.0, 2017-01-01 Acinetobact
Page 7 and 8: Enterobacteriaceae EUCAST Clinical
Page 9: Enterobacteriaceae EUCAST Clinical
Page 13 and 14: Pseudomonas spp. EUCAST Clinical Br
Page 15 and 16: Pseudomonas spp. EUCAST Clinical Br
Page 17 and 18: Acinetobacter spp. EUCAST Clinical
Page 19 and 20: Acinetobacter spp. EUCAST Clinical
Page 21 and 22: Staphylococcus spp. EUCAST Clinical
Page 27 and 28: Enterococcus spp. EUCAST Clinical B
Page 29 and 30: Enterococcus spp. EUCAST Clinical B
Page 31 and 32: Streptococcus groups A, B, C and G
Page 37 and 38: Streptococcus pneumoniae EUCAST Cli
Page 43 and 44: Viridans group streptococci EUCAST
Page 45 and 46: Viridans group streptococci EUCAST
Page 47 and 48: Haemophilus influenzae EUCAST Clini
Page 53 and 54: Moraxella catarrhalis EUCAST Clinic
Page 55 and 56: Moraxella catarrhalis EUCAST Clinic
Page 57 and 58: Neisseria gonorrhoeae EUCAST Clinic
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Neisseria meningitidis EUCAST Clini
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Neisseria meningitidis EUCAST Clini
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Gram-positive anaerobes except Clos
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Gram-positive anaerobes except Clos
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Clostridium difficile EUCAST Clinic
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Gram-negative anaerobes EUCAST Clin
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Gram-negative anaerobes EUCAST Clin
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Listeria monocytogenes EUCAST Clini
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Pasteurella multocida EUCAST Clinic
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Corynebacterium spp. EUCAST Clinica
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Aerococcus sanguinicola and urinae
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Kingella kingae EUCAST Clinical Bre
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Mycobacterium tuberculosis EUCAST C
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PK/PD (Non-species related) breakpo
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PK/PD (Non-species related) breakpo
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Dosages EUCAST Clinical Breakpoint
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Dosages EUCAST Clinical Breakpoint
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European Committee on Antimicrobial Susceptibility Testing

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