European Committee on Antimicrobial Susceptibility Testing

Recommendations

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Enterococcus spp. EUCAST Clinical Breakpoint Tables v. 7.0, valid from 2017-01-01 Miscellaneous agents (µg) (mm) S ≤ R > S ≥ R < Chloramphenicol - - - - Colistin - - - - Daptomycin 1 IE IE IE IE Fosfomycin iv - - - - Fosfomycin oral - - - - Fusidic acid - - - - Metronidazole - - - - Mupirocin MIC breakpoint (mg/L) Disk content Zone diameter breakpoint Nitrofurantoin (uncomplicated UTI only), E. faecalis 64 64 100 15 15 Nitroxoline (uncomplicated UTI only) IE IE IE IE Rifampicin - - - - Spectinomycin - - - - Trimethoprim (uncomplicated UTI only) 0.03 2 1 5 50 A 21 Trimethoprim-sulfamethoxazole 3 0.03 2 1 1.25-23.75 50 A 21 Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1. For more information, see http://www.eucast.org/guidance_documents/. 2/A. The activity of trimethoprim and trimethoprim-sulfamethozaxole is uncertain against enterococci, hence the wild type population is categorised as intermediate. 3. Trimethoprim-sulfamethoxazole in the ratio 1:19. Breakpoints are expressed as the trimethoprim concentration. a) b) c) d) Examples of inhibition zones for Enterococcus spp. with vancomycin. a) Sharp zone edge and zone diameter ≥ 12 mm. Report susceptible. b-d) Fuzzy zone edge or colonies within zone. Perform confirmatory testing with PCR or report resistant even if the zone diameter ≥ 12 mm. 29
Streptococcus groups A, B, C and G EUCAST Clinical Breakpoint Tables v. 7.0, valid from 2017-01-01 Disk diffusion (EUCAST standardised disk diffusion method) Medium: Mueller-Hinton agar + 5% defibrinated horse blood and 20 mg/L β-NAD (MH-F) Inoculum: McFarland 0.5 Incubation: 5% CO 2 , 35±1ºC, 18±2h Reading: Read zone edges as the point showing no growth viewed from the front of the plate with the lid removed and with reflected light. Quality control: Streptococcus pneumoniae ATCC 49619 Penicillins 1 MIC breakpoint (mg/L) Disk content Zone diameter breakpoint (µg) (mm) S ≤ R > S ≥ R < Benzylpenicillin 2 0.25 0.25 1 unit 18 18 Ampicillin Note 1 Note 1 Note A Note A Ampicillin-sulbactam 3 Note 1 Note 1 Note A Note A Amoxicillin Note 1 Note 1 Note A Note A Amoxicillin-clavulanic acid 3 Note 1 Note 1 Note A Note A Piperacillin Note 1 Note 1 Note A Note A Piperacillin-tazobactam 3 Note 1 Note 1 Note A Note A Ticarcillin - - - - Ticarcillin-clavulanic acid - - - - Temocillin - - - - Notes Numbered notes relate to general comments and/or MIC breakpoints. Lettered notes relate to the disk diffusion method. 1/A. The susceptibility of streptococcus groups A, B, C and G to penicillins is inferred from the benzylpenicillin susceptibility with the exception of phenoxymethylpenicillin and isoxazolylpenicillins for streptococcus group B. 2. Non-susceptible isolates are rare or not yet reported. The identification and antimicrobial susceptibility test result on any such isolate must be confirmed and the isolate sent to a reference laboratory. 3. Streptococcus groups A, B, C and G do not produce beta-lactamase. The addition of a beta-lactamase inhibitor does not add clinical benefit. Phenoxymethylpenicillin Streptococcus groups A, C and G Note 1 Note 1 Note A Note A Oxacillin Streptococcus groups A, C and G Cloxacillin Streptococcus groups A, C and G Dicloxacillin Streptococcus groups A, C and G Flucloxacillin Streptococcus groups A, C and G NA NA NA NA Note 1 Note 1 Note A Note A Note 1 Note 1 Note A Note A Note 1 Note 1 Note A Note A Mecillinam (uncomplicated UTI only) - - - - 30
Page 1 and 2: European C
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 and 22: Staphylococcus spp. EUCAST Clinical
Page 27 and 28: Enterococcus spp. EUCAST Clinical B
Page 29: Enterococcus spp. EUCAST Clinical B
Page 33 and 34: Streptococcus groups A, B, C and G
Page 35 and 36: 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
Page 59 and 60: Neisseria gonorrhoeae EUCAST Clinic
Page 61 and 62: Neisseria meningitidis EUCAST Clini
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
Page 69 and 70: Clostridium difficile EUCAST Clinic
Page 71 and 72: Gram-negative anaerobes EUCAST Clin
Page 73 and 74: Gram-negative anaerobes EUCAST Clin
Page 75 and 76: Listeria monocytogenes EUCAST Clini
Page 77 and 78: Pasteurella multocida EUCAST Clinic
Page 79 and 80: 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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