European Committee on Antimicrobial Susceptibility Testing - eucast

More documents

Recommendations

Info

Staphylococcus spp. Monobactams Aztreonam - - - - Moxifloxacin 0.5 1 5 24 21 Nalidixic acid (screen) NA NA NA NA Norfloxacin (screen) NA NA 10 17 A Ofloxacin 2 1 1 5 20 20 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 MIC breakpoint Disk Zone diameter Notes (mg/L) content breakpoint (mm) Numbers for comments on MIC breakpoints (µg) Letters for comments on disk diffusion S ≤ R > S ≥ R < EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01 S ≤ R > S ≥ R < Ciprofloxacin 1. Regarding breakpoints for other fluoroquinolones (e.g. pefloxacin and enoxacin) - refer to breakpoints determined by national breakpoint committees. 2 Fluoroquinolones 1 1 5 20 20 2. Breakpoints relate to high dose therapy. Levofloxacin 1 2 5 22 19 1 MIC breakpoint Disk Zone diameter Notes (mg/L) content breakpoint (mm) Numbers for comments on MIC breakpoints (µg) Letters for comments on disk diffusion 17 A A. The norfloxacin disk diffusion test can be used to screen for fluoroquinolone resistance. Isolates categorised as susceptible can be reported susceptible to ciprofloxacin, levofloxacin, moxifloxacin and ofloxacin. Isolates categorised as resistant should be tested for susceptibility to individual agents. S ≤ R > S ≥ R < Amikacin 1. Aminoglycoside breakpoints are based on once-daily administration of high aminoglycoside dosages. Most often aminoglycosides are given in combination with beta-lactam agents. 2 S. aureus 8 16 30 18 16 2. Resistance to amikacin is most reliably determined by testing with kanamycin (zone diameter breakpoints under development). Amikacin 2 Aminoglycosides MIC breakpoint Disk Notes (mg/L) content Numbers for comments on MIC breakpoints (µg) Letters for comments on disk diffusion Coagulase-negative staphylococci 8 16 30 22 19 Gentamicin S. aureus 1 1 10 18 18 1 Zone diameter breakpoint (mm) 19
Staphylococcus spp. Teicoplanin, S. aureus 2 2 Note A Teicoplanin, Coagulase-negative staphylococci 4 4 Note A Telavancin, MRSA 1 1 Note A Vancomycin, S. aureus 2 2 Note A Vancomycin, Coagulase-negative staphylococci 4 4 Note A Azithromycin 1 1 Clarithromycin 1 1 Erythromycin 1 2 15 21 18 Roxithromycin 1 1 Telithromycin IE IE IE IE Clindamycin 2 0.25 0.5 2 22 B Quinupristin-dalfopristin 1 2 15 21 C Doxycycline 1 1 2 1 2 1 2 1 2 1 Note A Note A Note A Note A EUCAST Clinical Breakpoint Table v. 2.0, valid from 2012-01-01 Glycopeptides Disk Zone diameter content breakpoint (mm) (µg) S ≤ R > S ≥ R < 1. Glycopeptide MICs are method dependent and should be determined by broth microdilution (reference ISO 20776). S. aureus with vancomycin MIC values of 2 mg/L are on the border of the wild type MIC distribution and there may be an impaired clinical response. The resistant breakpoint has been reduced to 2 mg/L to avoid reporting "GISA" isolates intermediate as serious infections with "GISA" isolates are not treatable with increased doses of vancomycin or teicoplanin. 1 MIC breakpoint Notes (mg/L) Numbers for comments on MIC breakpoints Letters for comments on disk diffusion Macrolides, lincosamides and streptogramins MIC breakpoint Disk Zone diameter Notes (mg/L) content breakpoint (mm) Numbers for comments on MIC breakpoints (µg) Letters for comments on disk diffusion S ≤ R > S ≥ R < Note A A. Disk diffusion is unreliable and cannot distinguish between wild type isolates and those with non-vanA -mediated resistance. Note A Note A Note A Note A Note A 1/A. Erythromycin can be used to determine susceptibility to azithromycin, clarithromycin and roxithromycin. Tetracyclines MIC breakpoint Disk Zone diameter Notes (mg/L) content breakpoint (mm) Numbers for comments on MIC breakpoints (µg) Letters for comments on disk diffusion S ≤ R > S ≥ R < Note A Note A 19 B 2/B. Inducible clindamycin resistance can be detected only in the presence of a macrolide antibiotic. In disk diffusion tests look for apparent antagonism of clindamycin by erythromycin (D-test). 18 C C. Isolates non-susceptible by disk diffusion should be confirmed by MIC testing. Note A 1/A. Isolates susceptible to tetracycline are also susceptible to doxycycline and minocycline, but some resistant to tetracycline may be susceptible to minocycline and/or doxycycline. An MIC method should be used to test doxycycline susceptibility of tetracycline resistant isolates if required. Minocycline 0.5 1 1 1 30 23 A 20 A Tetracycline 1 1 2 1 30 22 A 19 A Tigecycline 0.5 2 0.5 15 18 18 2. Isolates with MIC values above the susceptible breakpoint are very rare or not yet reported. The identification and antimicrobial susceptibility tests on any such isolate must be repeated and if the result is confirmed the isolate sent to a reference laboratory. Until there is evidence regarding clinical response for confirmed isolates with MIC values above the current resistant breakpoint they should be reported resistant. 20
Page 1 and 2: European C
Page 3 and 4: European C
Page 5 and 6: Enterobacteriaceae Cefaclor - - - -
Page 7 and 8: Enterobacteriaceae Glycopeptides MI
Page 9 and 10: Pseudomonas spp. Penicillins Benzyl
Page 11 and 12: Pseudomonas spp. Fluoroquinolones M
Page 13 and 14: Stenotrophomonas maltophilia Antibi
Page 15 and 16: Acinetobacter spp. Cephalosporins C
Page 17 and 18: Acinetobacter spp. Macrolides, linc
Page 19: Staphylococcus spp. Cefalexin Note
Page 23 and 24: Enterococcus spp. In endocarditis,
Page 25 and 26: Enterococcus spp. Fluoroquinolones
Page 27 and 28: Enterococcus spp. Tetracyclines MIC
Page 29 and 30: Streptococcus groups A, B, C and G
Page 31 and 32: Streptococcus groups A, B, C and G
Page 33 and 34: Streptococcus pneumoniae EUCAST Cli
Page 35 and 36: Streptococcus pneumoniae Monobactam
Page 37 and 38: Streptococcus pneumoniae Tetracycli
Page 39 and 40: Viridans group streptococci Cephalo
Page 41 and 42: Viridans group streptococci Macroli
Page 43 and 44: Haemophilus influenzae Cephalospori
Page 45 and 46: Haemophilus influenzae Glycopeptide
Page 47 and 48: Moraxella catarrhalis Penicillins M
Page 49 and 50: Moraxella catarrhalis Fluoroquinolo
Page 51 and 52: Neisseria gonorrhoeae EUCAST Clinic
Page 53 and 54: Neisseria gonorrhoeae Fluoroquinolo
Page 55 and 56: Neisseria meningitidis Benzylpenici
Page 57 and 58: Neisseria meningitidis Fluoroquinol
Page 59 and 60: Gram-positive anaerobes except Clos
Page 61 and 62: Gram-positive anaerobes except Clos
Page 63 and 64: Clostridium difficile Antibiotic ag
Page 65 and 66: Gram-negative anaerobes Carbapenems
Page 67 and 68: Gram-negative anaerobes Tetracyclin
Page 69 and 70: Listeria monocytogenes Antibiotic a
Page 71 and 72:
Non-species related breakpoints Car
Page 73:
Non-species related breakpoints Tet
show all

European Committee on Antimicrobial Susceptibility Testing - eucast

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?