European Committee on Antimicrobial Susceptibility Testing

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Staphylococcus spp. EUCAST Clinical Breakpoint Tables v. 7.0, valid from 2017-01-01 Cephalosporins 1 (µg) (mm) S ≤ R > S ≥ R < Cefaclor 2 Note 1 Note 1 Note A Note A Cefadroxil Note 1 Note 1 Note A Note A Cefalexin Note 1 Note 1 Note A Note A Cefazolin Note 1 Note 1 Note A Note A Cefepime Note 1 Note 1 Note A Note A Cefixime - - - - Cefotaxime Note 1 Note 1 Note A Note A Cefoxitin (screen), S. aureus and coagulase-negative staphylococci other than S. epidermidis MIC breakpoint (mg/L) Disk content Zone diameter breakpoint Note 3,4 Note 3,4 30 22 A,B 22 A,B Cefoxitin (screen), S. epidermidis Note 4 Note 4 30 28 A,B 28 A,B Cefoxitin (screen), S. pseudintermedius Note 4 Note 4 30 35 A 35 A Cefpodoxime Note 1 Note 1 Note A Note A Ceftaroline, S. aureus 1 5 1 5 5 20 C 20 C Ceftazidime - - - - Ceftazidime-avibactam - - - - Ceftibuten - - - - Ceftobiprole, S. aureus 2 6 2 6 5 17 D 17 D Ceftolozane-tazobactam - - - - Ceftriaxone Note 1 Note 1 Note A Note A Cefuroxime iv Note 1 Note 1 Note A Note A Cefuroxime oral Note 1 Note 1 Note A Note A Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1/A. Susceptibility of staphylococci to cephalosporins is inferred from the cefoxitin susceptibility except for cefixime, ceftazidime, ceftazidime-avibactam, ceftibuten and ceftolozane-tazobactam, which do not have breakpoints and should not be used for staphylococcal infections. Some methicillin-resistant S. aureus are susceptible to ceftaroline and ceftobiprole, see Notes 5/C and 6/D. 2. Breakpoints are based on a minimum dose of 500 mg x 3. 3. S. aureus and S. lugdunensis with cefoxitin MIC values >4 mg/L and S. saprophyticus with cefoxitin MIC values >8 mg/L are methicillin resistant, mostly due to the presence of the mecA or mecC gene. Disk diffusion reliably predicts methicillin resistance. 4. For staphylococci other than S. aureus, S. lugdunensis and S. saprophyticus , the cefoxitin MIC is a poorer predictor of methicillin resistance than the disk diffusion test. 5/C. Methicillin-susceptible isolates can be reported susceptible to ceftaroline without further testing. 6/D. Methicillin-susceptible isolates can be reported susceptible to ceftobiprole without further testing. B. If coagulase-negative staphylococci are not identified to species level use zone diameter breakpoints S≥25, R S ≥ R < Doripenem Note 1 Note 1 Note A Note A Ertapenem Note 1 Note 1 Note A Note A Imipenem Note 1 Note 1 Note A Note A Meropenem Note 1 Note 1 Note A Note A Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1/A. Susceptibility of staphylococci to carbapenems is inferred from the cefoxitin susceptibility. Monobactams MIC breakpoint (mg/L) Disk content Zone diameter breakpoint (µg) (mm) S ≤ R > S ≥ R < Aztreonam - - - - Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 21
Staphylococcus spp. EUCAST Clinical Breakpoint Tables v. 7.0, valid from 2017-01-01 Fluoroquinolones 1 MIC breakpoint (mg/L) Disk content Zone diameter breakpoint (µg) (mm) S ≤ R > S ≥ R < Ciprofloxacin 2 , S. aureus 1 1 5 21 A 21 A Ciprofloxacin 2 , Coagulase-negative staphylococci 1 1 5 24 A 24 A Levofloxacin, S. aureus 1 1 5 22 A 22 A Levofloxacin, Coagulase-negative staphylococci 1 1 5 24 A 24 A Moxifloxacin, S. aureus 0.25 0.25 5 25 A 25 A Moxifloxacin, Coagulase-negative staphylococci 0.25 0.25 5 28 A 28 A Nalidixic acid (screen) NA NA NA NA Norfloxacin (screen) NA NA 10 17 B Note B Ofloxacin 3 , S. aureus 1 1 5 20 A 20 A Ofloxacin 3 , Coagulase-negative staphylococci 1 1 5 24 A 24 A Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1. For breakpoints for other fluoroquinolones (e.g. pefloxacin and enoxacin), refer to breakpoints set by national breakpoint committees. 2. Breakpoints are based on high dose therapy (oral dose of 0.75 g x 2, iv dose of 0.4 g x 3). 3. Breakpoints are based on high dose therapy (0.4 g x 2). A. The norfloxacin disk diffusion test can be used to screen for fluoroquinolone resistance. See Note B. B. Isolates categorised as susceptible to norfloxacin can be reported susceptible to ciprofloxacin, levofloxacin, moxifloxacin and ofloxacin. Isolates categorised as non-susceptible should be tested for susceptibility to individual agents. Aminoglycosides 1 MIC breakpoint (mg/L) Disk content Zone diameter breakpoint (µg) (mm) S ≤ R > S ≥ R < Amikacin 2 , S. aureus 8 16 30 18 16 Amikacin 2 , Coagulase-negative staphylococci 8 16 30 22 19 Gentamicin, S. aureus 1 1 10 18 18 Gentamicin, Coagulase-negative staphylococci 1 1 10 22 22 Netilmicin, S. aureus 1 1 10 18 18 Netilmicin, Coagulase-negative staphylococci 1 1 10 22 22 Tobramycin, S. aureus 1 1 10 18 18 Tobramycin, Coagulase-negative staphylococci 1 1 10 22 22 Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1. Aminoglycoside breakpoints are based on once-daily administration. 2. Resistance to amikacin is most reliably determined by testing with kanamycin (MIC >8 mg/L). The corresponding zone diameter for the kanamyicn 30 µg disk is R
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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 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: Staphylococcus spp. EUCAST Clinical
Page 25 and 26: 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
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Page 43 and 44: Viridans group streptococci EUCAST
Page 45 and 46: Viridans group streptococci EUCAST
Page 47 and 48: Haemophilus influenzae EUCAST Clini
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Page 63 and 64: Neisseria meningitidis EUCAST Clini
Page 65 and 66: Gram-positive anaerobes except Clos
Page 67 and 68: Gram-positive anaerobes except Clos
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Page 71 and 72: 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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