This document is protected by international copyright laws.

Size: px
Start display at page:

Download "This document is protected by international copyright laws."

Transcription

1 Table 2C Table 2C. and s for Product Name: Infobase Release Date: February Clinical and Laboratory Standards Institute. All rights reserved. Testing Conditions Medium: diffusion: MHA Broth dilution: CAMHB; CAMHB + 2% NaCl for oxacillin, methicillin, and nafcillin; CAMHB supplemented to 50 µg/ml calcium for daptomycin Agar dilution: MHA; MHA + 2% NaCl for oxacillin, methicillin, and nafcillin. Agar dilution has not been validated for daptomycin. Inoculum: Direct colony suspension, equivalent to a 0.5 McFarland standard Incubation: 35 ± 2 C; ambient air; diffusion: 16 to 18 hours; 24 hours (coagulase-negative staphylococci and cefoxitin); Dilution methods: 16 to 20 hours; All methods: 24 hours for oxacillin, methicillin, nafcillin, and vancomycin. Testing at temperatures above 35 C may not detect MRS. Refer to Supplemental Tables 2C-S3 and 2C-S4 at the end of Table 2C for additional recommendations for testing conditions, reporting suggestions, and QC. General Minimal QC Recommendations (See Tables 3 and 4 for acceptable QC ranges.) Staphylococcus aureus ATCC ( diffusion) Staphylococcus aureus ATCC (MIC) Escherichia coli ATCC (for β-lactam/β-lactamase inhibitor combinations) (1) For disk diffusion, measure the diameter of the zones of complete inhibition (as judged by the unaided eye), including the diameter of the disk. Hold the Petri plate a few inches above a black, nonreflecting background illuminated with reflected light, except for linezolid, oxacillin, and vancomycin, which should be read with transmitted light (plate held up to light source). The zone margin should be considered the area showing no obvious, visible growth that can be detected with the unaided eye. Ignore faint growth of tiny colonies that can be detected only with a magnifying lens at the edge of the zone of inhibited growth. With trimethoprim and the sulfonamides, antagonists in the medium may allow some slight growth; therefore, disregard slight growth (20% or less of the lawn of growth) and measure the more obvious margin to determine the zone diameter. Any discernable growth within the zone of inhibition is indicative of oxacillin, linezolid, or vancomycin resistance. (2) Historically, resistance to the penicillinase-stable penicillins (see Glossary I) has been referred to as methicillin resistance or oxacillin resistance. MRSAs are those strains of that express meca or another mechanism of methicillin resistance, such as changes in affinity of penicillin binding proteins for oxacillin (modified [MOD-SA] strains). (3) For oxacillin-susceptible and coagulase-negative staphylococci, results for parenteral and oral cephems, β-lactam/β-lactamase inhibitor combinations, and carbapenems, if tested, should be reported according to the results generated using routine interpretive criteria. See comment (4) for reporting β-lactam results on oxacillin-resistant strains. (4) WARNING: For oxacillin-resistant and coagulase-negative staphylococci (MRS), other β-lactam agents, ie, penicillins, β-lactam/β-lactamase inhibitor combinations, cephems (with the exception of the newer cephalosporins with anti-mrsa activity ), and carbapenems, may appear active in vitro but are not effective clinically. Results for β-lactam agents other than the cephalosporins with anti-mrsa activity should be reported as resistant or should not be reported. This is because most cases of documented MRS infections have responded poorly to β-lactam therapy, or because convincing clinical data have yet to be presented that document clinical efficacy for those agents.

2 Clinical and Laboratory Standards Institute. All rights reserved. 61 (5) Detection of oxacillin resistance: Tests for meca or for the protein expressed by meca, the penicillin-binding protein 2a (PBP 2a, also called PBP2'), are the most accurate methods for prediction of resistance to oxacillin and can be used to confirm results for isolates of staphylococci from serious infections. Isolates of staphylococci that carry the meca gene, or that produce PBP 2a (the meca gene product), should be reported as oxacillin resistant. Isolates that do not carry meca or do not produce PBP 2a should be reported as oxacillin susceptible. Because of the rare occurrence of resistance mechanisms other than meca, if MIC tests are performed in addition to disk diffusion, isolates for which oxacillin MICs are 4 μg/ml and are meca negative or PBP 2a negative should be reported as oxacillin resistant. These isolates may test as susceptible to cefoxitin by disk diffusion. (6) Routine testing of urine isolates of S. saprophyticus is not advised, because infections respond to concentrations achieved in urine of antimicrobial agents commonly used to treat acute, uncomplicated urinary tract infections (eg, nitrofurantoin, trimethoprim ± sulfamethoxazole, or a fluoroquinolone). (7) For some organism/antimicrobial agent combinations, the absence or rare occurrence of resistant strains precludes defining any results categories other than susceptible. For strains yielding results suggestive of a nonsusceptible category, organism identification and antimicrobial susceptibility test results should be confirmed. (See Appendix A.) (8) For screening tests for β-lactamase production, oxacillin resistance, meca-mediated oxacillin resistance using cefoxitin, reduced susceptibility to vancomycin, and inducible clindamycin resistance, refer to Supplemental Table 2C-S3 at the end of Table 2C for group and Supplemental Table 2C-S4 for coagulase-negative staphylococci at the end of Table 2C. In addition, further explanation on the use of cefoxitin for prediction of mecamediated oxacillin resistance can be found in Section 12 of M07-A8 and Section 11 of M02-A10. NOTE: Information in boldface type is considered tentative for one year. For Use With M02-A10 and M07-A8 M100-S20 Table 2C

3 Table 2C Product Name: Infobase Release Date: February Clinical and Laboratory Standards Institute. All rights reserved. Test/Report PENICILLINS Antimicrobial Content S I R S I R (9) Penicillin-susceptible staphylococci are also susceptible to other penicillins, β-lactam/β-lactamase inhibitor combinations, cephems, and carbapenems approved for use by the FDA for staphylococcal infections. Penicillin-resistant, oxacillin-susceptible strains are resistant to penicillinase-labile penicillins but susceptible to other penicillinase-stable penicillins, β- lactam/β-lactamase inhibitor combinations, relevant cephems, and carbapenems. Oxacillin-resistant staphylococci are resistant to all currently available β-lactam antimicrobial agents with the exception of the newer cephalosporins with anti-mrsa activity. Thus, susceptibility or resistance to a wide array of β-lactam antimicrobial agents may be deduced from testing only penicillin and either cefoxitin or oxacillin. Routine testing of other penicillins, β-lactam/β-lactamase inhibitor combinations, cephems, or carbapenems is not advised. (10) If a penicillinase-stable penicillin is tested, oxacillin is the preferred agent and results can be applied to the other penicillinase-stable penicillins, cloxacillin, dicloxacillin, flucloxacillin, methicillin, and nafcillin. See comment (4). A Penicillin 10 units (11) Penicillin-resistant strains of staphylococci produce β-lactamase, and the testing of penicillin instead of ampicillin is preferred. Penicillin should be used to test the susceptibility of all staphylococci to all penicillinase-labile penicillins, such as ampicillin, amoxicillin, azlocillin, carbenicillin, mezlocillin, piperacillin, and ticarcillin. An induced β-lactamase test should be performed on staphylococcal isolates with penicillin MICs 0.12 µg/ml or zone diameters 29 mm before reporting the isolate as penicillin susceptible. However, the prevalence of penicillinsusceptible strains is low. Isolates that test as susceptible to penicillin may still produce β-lactamase, which is usually detected by an induced β-lactamase test. Occasional isolates are not detected by induced β-lactamase testing. Thus, for serious infections, laboratories should consider performing MIC tests for penicillin and testing for induced β-lactamase production on subsequent isolates from the same patient. A positive β- lactamase test predicts resistance to penicillin, ampicillin, amoxicillin, carbenicillin, ticarcillin, mezlocillin, and piperacillin. For oxacillin-resistant staphylococci, report penicillin as resistant or do not report. See Supplemental Table 2C-S3 and Table 2C- S4 at the end of Table 2C. A Oxacillin For and S. lugdunensis. 1 μg oxacillin (oxacillin 1 μg oxacillin 2 (oxacillin) 30 µg cefoxitin (cefoxitin) 4 (oxacillin) 4 (oxacillin) 8 (cefoxitin) For. For S. lugdunensis. For and S. lugdunensis. (12) Cefoxitin is used as a surrogate for oxacillin resistance; report oxacillin susceptible or resistant based on the cefoxitin result. If both cefoxitin and oxacillin are tested against or S. lugdunensis and either result is resistant, the organism should be reported as oxacillin resistant. See comment (9).

4 Clinical and Laboratory Standards Institute. All rights reserved. 63 Test/Report A Antimicrobial Oxacillin For coagulasenegative staphylococci except S. lugdunensis. Content 1 μg oxacillin 0.25 (oxacillin) 30 μg cefoxitin S I R S I R 0.5 (oxacillin) See comment (12). See comment (9). For coagulase-negative staphylococci except S. lugdunensis. (13) Oxacillin interpretive criteria may overcall resistance for some coagulase-negative staphylococci because some non S. epidermidis strains for which the oxacillin MICs are 0.5 to 2 µg/ml lack meca. For serious infections with coagulase-negative staphylococci other than S. epidermidis, testing for meca or for PBP 2a or with cefoxitin disk diffusion may be appropriate for strains for which the oxacillin MICs are 0.5 to 2 µg/ml. For Use With M02-A10 and M07-A8 M100-S20 Table 2C

5 Table 2C Product Name: Infobase Release Date: February Clinical and Laboratory Standards Institute. All rights reserved. Test/Report Antimicrobial PENICILLINS (Continued) Content S I R S I R O Ampicillin 10 μg (14) Class representative for ampicillin and amoxicillin. (15) For oxacillin-resistant staphylococci, report ampicillin as resistant or do not report. O Methicillin 5 μg (16) For use with only. O Nafcillin 1 μg See comment (16). β-lactam/β-lactamase INHIBITOR COMBINATIONS (17) For oxacillin-resistant staphylococci, report as resistant or do not report. See comments (4) and (9). O Amoxicillin-clavulanic acid 20/10 μg /2 8/4 O Ampicillin-sulbactam 10/10 μg /4 16/8 32/16 O Piperacillin-tazobactam 100/10 μg /4 16/4 O Ticarcillin-clavulanic acid 75/10 μg /2 16/2 CEPHEMS (PARENTERAL) (Including cephalosporins I, II, III, and IV. Please refer to Glossary I.) See comment (17). See comments (4) and (9). O Cefamandole 30 μg O Cefazolin 30 μg O Cefepime 30 μg O Cefmetazole 30 μg O Cefonicid 30 μg O Cefoperazone 75 μg O Cefotaxime 30 μg O Cefotetan 30 μg O Ceftazidime 30 μg O Ceftizoxime 30 μg O Ceftriaxone 30 μg O Cefuroxime (parenteral) 30 μg O Cephalothin 30 μg O Moxalactam 30 μg CEPHEMS (ORAL) See comment (15). See comments (4) and (9). O Cefaclor 30 μg O Cefdinir 5 μg O Cefpodoxime 10 μg O Cefprozil 30 μg O Cefuroxime (oral) 30 μg O Loracarbef 30 μg

6 Clinical and Laboratory Standards Institute. All rights reserved. 65 Test/Report CARBAPENEMS See comment (17). See comments (4) and (9). Antimicrobial Content S I R S I R O Ertapenem 10 μg O Imipenem 10 μg O Meropenem 10 μg GLYCOPEPTIDES B Vancomycin For. (18) MIC tests should be performed to determine the susceptibility of all isolates of staphylococci to vancomycin. The disk test does not differentiate vancomycin-susceptible isolates of from vancomycin-intermediate isolates, nor does the test differentiate among vancomycin-susceptible, intermediate, and resistant isolates of coagulasenegative staphylococci, all of which will give similar size zones of inhibition. (19) The vancomycin 30-µg disk test detects S. aureus isolates containing the vana vancomycin resistance gene (VRSA). Such isolates will show no zone of inhibition around the disk (zone = 6 mm). The identification of isolates showing no zone of inhibition should be confirmed. Isolates of staphylococci producing vancomycin zones of 7 mm should not be reported as susceptible without performing a vancomycin MIC test. (20) Send any for which the vancomycin is 8 μg/ml to a reference laboratory. (21) testing is not reliable for testing vancomycin. Also refer to Supplemental Table 2C-S3 for S. aureus at the end of Table 2C, Section in M07-A8, and Section in M02-A10. For Use With M02-A10 and M07-A8 M100-S20 Table 2C

7 Table 2C Product Name: Infobase Release Date: February Clinical and Laboratory Standards Institute. All rights reserved. Test/Report Antimicrobial GLYCOPEPTIDES (Continued) Content S I R S I R B Vancomycin For coagulase-negative staphylococci. See comments (18) and (21). (22) Send any coagulase-negative Staphylococcus for which the vancomycin MIC is 32 μg/ml to a reference laboratory. See also Section in M07-A8 and Section in M02-A10. Inv. Teicoplanin 30 μg (23) Teicoplanin disk diffusion interpretive criteria were not reevaluated concurrent with the reevaluation of vancomycin disk diffusion interpretive criteria during recent studies. Therefore, the ability of these teicoplanin interpretive criteria to differentiate teicoplaninintermediate and teicoplanin-resistant staphylococci from teicoplanin-susceptible strains is not known. LIPOPEPTIDES B Daptomycin 1 (24) testing is not reliable for testing daptomycin. See comment (7). AMINOGLYCOSIDES C Gentamicin 10 μg O Amikacin 30 μg O Kanamycin 30 μg O Netilmicin 30 μg O Tobramycin 10 μg MACROLIDES (25) Not routinely reported on organisms isolated from the urinary tract. A A A Azithromycin or clarithromycin or erythromycin 15 μg 15 μg 15 μg O Dirithromycin 15 μg KETOLIDES B Telithromycin 15 μg

8 Clinical and Laboratory Standards Institute. All rights reserved. 67 Test/Report TETRACYCLINES Antimicrobial Content S I R S I R (26) Organisms that are susceptible to tetracycline are also considered susceptible to doxycycline and minocycline. However, some organisms that are intermediate or resistant to tetracycline may be susceptible to doxycycline, minocycline, or both. B Tetracycline 30 μg B Doxycycline 30 μg O Minocycline 30 μg FLUOROQUINOLONES (27) may develop resistance during prolonged therapy with quinolones. Therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. Testing of repeat isolates may be warranted. C Ciprofloxacin or 5 μg C levofloxacin or 5 μg C ofloxacin 5 μg C Moxifloxacin 5 μg U Lomefloxacin 10 μg U Norfloxacin 10 μg O Enoxacin 10 μg (28) FDA approved for S. saprophyticus and S. epidermidis (but not for ). O Gatifloxacin 5 μg O Grepafloxacin 5 μg O Sparfloxacin 5 μg Inv. Fleroxacin 5 μg For Use With M02-A10 and M07-A8 M100-S20 Table 2C

9 Table 2C Product Name: Infobase Release Date: February Clinical and Laboratory Standards Institute. All rights reserved. Test/Report Antimicrobial Content S I R S I R NITROFURANTOINS U Nitrofurantoin 300 μg LINCOSAMIDES A Clindamycin 2 μg (29) Inducible clindamycin resistance can be detected by disk diffusion using the D-zone test and by broth using a single well containing a combination of erythromycin and clindamycin. See Supplemental Tables 2C-S3 and 2C-S4, Section 12 in M02-A10, and Section 13 in M07-A8 for current recommendations. See comment (25). FOLATE PATHWAY INHIBITORS A Trimethoprim- 1.25/23.75 μg /38 4/76 sulfamethoxazole U Sulfonamides 250 or 300 μg (30) Sulfisoxazole can be used to represent any of the currently available sulfonamide preparations. U Trimethoprim 5 μg PHENICOLS C Chloramphenicol 30 μg See comment (25). ANSAMYCINS B Rifampin 5 μg (31) Rx: Rifampin should not be used alone for antimicrobial therapy. STREPTOGRAMINS C Quinupristindalfopristin 15 μg (32) For reporting against methicillin-susceptible. OXAZOLIDINONES B Linezolid 30 μg (33) When testing linezolid, disk diffusion zones should be examined using transmitted light. Organisms with resistant results by disk diffusion should be confirmed using an MIC method.

10 70 Clinical and Laboratory Standards Institute. All rights reserved. Supplemental Table 2C-S3. Screening Tests for β-lactamase Production, Oxacillin Resistance, meca-mediated Oxacillin Resistance Using Cefoxitin, Vancomycin MIC 8 μg/ml, Inducible Clindamycin Resistance, and High-Level Mupirocin Resistance in the Staphylococcus aureus for Use With Table 2C Screen Test β-lactamase Oxacillin Resistance meca-mediated Oxacillin Resistance Using Cefoxitin Organism and S. and group lugdunensis with S. lugdunensis penicillin MICs 0.12 µg/ml or zones 29 mm Test method Nitrocefin-based test Agar dilution diffusion Broth Medium NA MHA with 4% NaCl Clinical and Laboratory Standards Institute. All rights reserved. 109 Antimicrobial concentration Inoculum Incubation conditions Incubation length NA Induced growth (ie, growth taken from the zone margin surrounding an oxacillin or cefoxitin disk test on either MHA or a blood agar plate after hours of incubation). Room temperature Up to 1 hour for nitrocefin-based test or follow manufacturer s directions 6 μg/ml oxacillin Direct colony suspension to obtain 0.5 McFarland turbidity. Using a 1-μL loop that was dipped in the suspension, spot an area 10 to 15 mm in diameter. Alternatively, using a swab dipped in the suspension and expressed, spot a similar area or streak an entire quadrant C; ambient air. (Testing at temperatures above 35 C may not detect MRSA.) 24 hours; read with transmitted light MHA CAMHB a Brain Heart Infusion (BHI) agar 30 µg cefoxitin disk Standard disk diffusion recommendations C; ambient air. (Testing at temperatures above 35 C may not detect MRSA.) 4 µg/ml cefoxitin 6 μg/ml vancomycin Standard broth recommendations C; ambient air. (Testing at temperatures above 35 C may not detect MRSA.) Vancomycin MIC 8 μg/ml Inducible Clindamycin Resistance and S. lugdunensis resistant to erythromycin and susceptible or intermediate to clindamycin High-level Mupirocin Resistance b,c Agar dilution diffusion Broth diffusion Broth MHA or blood CAMHB a MHA CAMHB a agar purity plate used with MIC tests Direct colony suspension to obtain 0.5 McFarland turbidity. Preferably, using a micropipette, spot a 10 μl drop onto agar surface. Alternatively, using a swab dipped in the suspension and the excess liquid expressed, spot an area 10 to 15 mm in diameter or streak a portion of the plate. 35 ± 2 C; ambient air hours hours 24 hours; read with transmitted light 15-µg erythromycin disk and 2-µg clindamycin disk spaced mm apart Standard disk diffusion Recommendations or heavily inoculated area of purity plate 35 ± 2 C; ambient air 4 µg/ml erythromycin and 0.5 µg/ml clindamycin in same well Standard broth recommendations 35 ± 2 C; ambient air 200-µg disk Standard disk diffusion recommendations 35 ± 2 C; ambient air hours hours 24 hours; read with transmitted light Supplemental Table 2C-S3 Screening Tests for Staphylococcus aureus Single 256-μg/mL well Standard broth recommendations 35 ± 2 C; ambient air 24 hours; read with transmitted light

11 Clinical and Laboratory Standards Institute. All rights reserved. 71 Supplemental Table 2C-S3. (Continued) Screen Test β-lactamase Oxacillin Resistance Test method Results Further testing and reporting meca-mediated Oxacillin Resistance Using Cefoxitin Nitrocefin-based test Agar dilution diffusion Broth Nitrocefin-based Examine 21 mm = meca >4 µg/ml = test: conversion from carefully with positive meca positive yellow to red/pink = transmitted light β-lactamase for > 1 colony or 22 mm = meca 4 µg/ml = positive. light film of negative meca growth. negative β-lactamasepositive staphylococci are resistant to penicillin, amino-, carboxy-, and ureidopenicillins. > 1 colony = oxacillin resistant. Oxacillinresistant staphylococci are resistant to all β-lactam agents; other β- lactam agents should be reported as resistant or should not be reported. Cefoxitin is used as a surrogate for meca-mediated oxacillin resistance. Isolates that test as meca positive should be reported as oxacillin (not cefoxitin) resistant; other β-lactam agents should be reported as resistant or should not be reported. Because of the rare occurrence of oxacillin resistance mechanisms other than meca, isolates that test as meca negative but for which the oxacillin MICs are resistant (MIC 4 µg/ml) should be reported as oxacillin resistant. Vancomycin Inducible Clindamycin Resistance MIC 8 μg/ml Agar dilution diffusion Broth Examine Any growth = carefully with inducible transmitted light clindamycin for > 1 colony or resistance; light film of growth. > 1 colony = presumptive reduced susceptibility to vancomycin. Perform a vancomycin MIC using a validated MIC method to determine vancomycin MICs on S. aureus that grow on BHI vancomycin screening agar. Testing on BHI vancomycin screening agar does not reliably detect all vancomycinintermediate S. aureus strains. Some strains for which the vancomycin MICs are 4 μg/ml will fail to grow. Flattening of the zone of inhibition adjacent to the erythromycin disk (referred to as a D- zone) = inducible clindamycin resistance. Hazy growth within the zone of inhibition around clindamycin = clindamycin resistance even if no D-zone apparent. Report isolates with inducible clindamycin resistance as clindamycin resistant. No growth = no inducible clindamycin resistance A comment that This isolate is presumed to be resistant based on detection of inducible clindamycin resistance. Clindamycin may still be effective in some patients may be included. High-level Mupirocin Resistance b,c diffusion Broth Examine carefully with transmitted light for light growth within the zone of inhibition. No zone = highlevel resistance Any zone = the absence of highlevel resistance Report isolates with no zone as high-level resistant. Report any zone of inhibition as the absence of highlevel resistance. For single 256- µg/ml well: Growth = highlevel resistance No growth = the absence of highlevel resistance Report growth in the 256-µg/mL well as high-level resistant. Report no growth in the 256-µg/mL well as the absence of highlevel resistance. For Use With M02-A10 and M07-A8 M100-S20 Supplemental Table 2C-S3 Screening Tests for Staphylococcus aureus

12 Supplemental Table 2C-S3 Screening Tests for Staphylococcus aureus 72 Clinical and Laboratory Standards Institute. All rights reserved. Supplemental Table 2C-S3. (Continued) Screen Test Test method β-lactamase Oxacillin Resistance meca-mediated Oxacillin Resistance Using Cefoxitin Nitrocefin-based test Agar dilution diffusion Broth positive negative (or see manufacturer s recommendations) ATCC Susceptible ATCC Resistant meca negative (zone mm) meca positive (zone 21 mm) ATCC meca negative (MIC 1-4 µg/ml) ATCC meca positive (MIC >4 µg/ml) Vancomycin MIC 8 μg/ml Inducible Clindamycin Resistance Agar dilution diffusion Broth Enterococcus faecalis ATCC Susceptible E. faecalis ATCC Resistant Footnotes for routine QC of disks; See Table 3 for use of supplemental QC strains QC recommendations ATCC BAA- 976 or ATCC no growth ATCC BAA-977 growth High-level Mupirocin Resistance b,c diffusion Broth (200-µg disk) mupa negative (zone 29 to 38 mm) BAA1708 mupa positive (no zone) mupa negative (MIC µg/ml) E. faecalis ATCC mupa negative (MIC 16 to 128 µg/ml) BAA1708 mupa positive (growth in 256-µg/mL well) a. CAMHB = cation-adjusted Mueller-Hinton broth. b. Although not formally validated by CLSI document M23 based analyses, some studies have linked a lack of response to -based decolonization regimens with isolates for which the MICs are 512. Although this document does not provide guidance on interpretive criteria for, disk-based testing and the MIC screening test described here identify isolates for which the MICs are 512 µg/ml. c. References: Simor AE. Randomized controlled trial of chlorhexidine gluconate for washing intranasal, and rifampin and doxycycline versus no treatment for the eradication of methicillinresistant Staphylococcus aureus colonization. Clin Infect Dis. 2007;44: ; Harbarth S, Dharan S, Liassine N, Herrault P, Auckenthaler R, Pittet D. Randomized, placebo-controlled, double-blind trial to evaluate the efficacy of for eradicating carriage of methicillin-resistant Staphylococcus aureus. Antimicrob s Chemother. 1999;43: ; and Walker ES, Vasquez JE, Dula R, Bullock H, Sarubbi FA. Mupirocin-resistant, methicillin-resistant Staphylococcus aureus; does remain effective? Infect Control Hosp Epidemiol. 2003;24:

January 2014 Vol. 34 No. 1

January 2014 Vol. 34 No. 1 January 2014 Vol. 34 No. 1. and Minimum Inhibitory Concentration (MIC) Interpretive Standards for Testing Conditions Medium: diffusion: Mueller-Hinton agar (MHA) Broth dilution: cation-adjusted Mueller-Hinton

More information

56 Clinical and Laboratory Standards Institute. All rights reserved.

56 Clinical and Laboratory Standards Institute. All rights reserved. Table 2C 56 Clinical and Laboratory Standards Institute. All rights reserved. Table 2C. Zone Diameter and Minimal Inhibitory Concentration Breakpoints for Testing Conditions Medium: Inoculum: diffusion:

More information

Antimicrobial Susceptibility Testing: The Basics

Antimicrobial Susceptibility Testing: The Basics Antimicrobial Susceptibility Testing: The Basics Susan E. Sharp, Ph.D., DABMM, FAAM Director, Airport Way Regional Laboratory Director, Regional Microbiology and Molecular Infectious Diseases Laboratories

More information

January 2014 Vol. 34 No. 1

January 2014 Vol. 34 No. 1 January 2014 Vol. 34 No. 1. and Minimal Inhibitory Concentration (MIC) Interpretive Standards for Testing Conditions Medium: diffusion: Mueller-Hinton agar (MHA) roth dilution: cation-adjusted Mueller-Hinton

More information

2016 Antibiotic Susceptibility Report

2016 Antibiotic Susceptibility Report Fairview Northland Medical Center and Elk River, Milaca, Princeton and Zimmerman Clinics 2016 Antibiotic Susceptibility Report GRAM-NEGATIVE ORGANISMS 2016 Gram-Negative Non-Urine The number of isolates

More information

2015 Antibiotic Susceptibility Report

2015 Antibiotic Susceptibility Report Citrobacter freundii Enterobacter aerogenes Enterobacter cloacae Escherichia coli Haemophilus influenzenza Klebsiella oxytoca Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens

More information

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی ویرایش دوم بر اساس ed., 2017 CLSI M100 27 th تابستان ۶۹۳۱ تهیه

More information

European Committee on Antimicrobial Susceptibility Testing

European Committee on Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Routine and extended internal quality control as recommended by EUCAST Version 5.0, valid from 015-01-09 This document should be cited as "The

More information

EUCAST recommended strains for internal quality control

EUCAST recommended strains for internal quality control EUCAST recommended strains for internal quality control Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus influenzae ATCC 59 ATCC

More information

Routine internal quality control as recommended by EUCAST Version 3.1, valid from

Routine internal quality control as recommended by EUCAST Version 3.1, valid from Routine internal quality control as recommended by EUCAST Version.1, valid from 01-01-01 Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus

More information

EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update

EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update EDUCATIONAL COMMENTARY - Methicillin-Resistant Staphylococcus aureus: An Update Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain

More information

European Committee on Antimicrobial Susceptibility Testing

European Committee on Antimicrobial Susceptibility Testing European Committee on Antimicrobial Susceptibility Testing Routine and extended internal quality control for MIC determination and disk diffusion as recommended by EUCAST Version 8.0, valid from 018-01-01

More information

a. 379 laboratories provided quantitative results, e.g (DD method) to 35.4% (MIC method) of all participants; see Table 2.

a. 379 laboratories provided quantitative results, e.g (DD method) to 35.4% (MIC method) of all participants; see Table 2. AND QUANTITATIVE PRECISION (SAMPLE UR-01, 2017) Background and Plan of Analysis Sample UR-01 (2017) was sent to API participants as a simulated urine culture for recognition of a significant pathogen colony

More information

The Basics: Using CLSI Antimicrobial Susceptibility Testing Standards

The Basics: Using CLSI Antimicrobial Susceptibility Testing Standards The Basics: Using CLSI Antimicrobial Susceptibility Testing Standards Janet A. Hindler, MCLS, MT(ASCP) UCLA Health System Los Angeles, California, USA jhindler@ucla.edu 1 Learning Objectives Describe information

More information

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST Help with moving disc diffusion methods from BSAC to EUCAST This document sets out the main differences between the BSAC and EUCAST disc diffusion methods with specific emphasis on preparation prior to

More information

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing These suggestions are intended to indicate minimum sets of agents to test routinely in a diagnostic laboratory

More information

What s new in EUCAST methods?

What s new in EUCAST methods? What s new in EUCAST methods? Derek Brown EUCAST Scientific Secretary Interactive question 1 MIC determination MH-F broth for broth microdilution testing of fastidious microorganisms Gradient MIC tests

More information

Performance Information. Vet use only

Performance Information. Vet use only Performance Information Vet use only Performance of plates read manually was measured in three sites. Each centre tested Enterobacteriaceae, streptococci, staphylococci and pseudomonas-like organisms.

More information

Antimicrobial Susceptibility Testing: Advanced Course

Antimicrobial Susceptibility Testing: Advanced Course Antimicrobial Susceptibility Testing: Advanced Course Cascade Reporting Cascade Reporting I. Selecting Antimicrobial Agents for Testing and Reporting Selection of the most appropriate antimicrobials to

More information

STAPHYLOCOCCI: KEY AST CHALLENGES

STAPHYLOCOCCI: KEY AST CHALLENGES Romney Humphries, PhD D(ABMM) Section Chief, UCLA Clinical Microbiology Los Angeles CA rhumphries@mednet.ucla.edu STAPHYLOCOCCI: KEY AST CHALLENGES THE CHALLENGES detection of penicillin resistance detection

More information

دکتر فرينبز راشذ مرنذی متخصص آسيب شنبسی تشريحی و ببلينی عضو هيئت علمی آزمبيشگبه مرجع سالمت

دکتر فرينبز راشذ مرنذی متخصص آسيب شنبسی تشريحی و ببلينی عضو هيئت علمی آزمبيشگبه مرجع سالمت دکتر فرينبز راشذ مرنذی متخصص آسيب شنبسی تشريحی و ببلينی عضو هيئت علمی آزمبيشگبه مرجع سالمت Antibiotical grouping Mechanisms of action Bacteriostatic Bacteriocidal Site of action Antibiotics Antibiotics

More information

Compliance of manufacturers of AST materials and devices with EUCAST guidelines

Compliance of manufacturers of AST materials and devices with EUCAST guidelines Compliance of manufacturers of AST materials and devices with EUCAST guidelines Data are based on questionnaires to manufacturers of materials and devices for antimicrobial susceptibility testing. The

More information

There are two international organisations that set up guidelines and interpretive breakpoints for bacteriology and susceptibility

There are two international organisations that set up guidelines and interpretive breakpoints for bacteriology and susceptibility ANTIMICROBIAL SUSCEPTIBILITY TESTING ON MILK SAMPLES Method and guidelines There are two international organisations that set up guidelines and interpretive breakpoints for bacteriology and susceptibility

More information

Brief reports. Heat stability of the antimicrobial activity of sixty-two antibacterial agents

Brief reports. Heat stability of the antimicrobial activity of sixty-two antibacterial agents Journal of Antimicrobial Chemotherapy (5) 35, -5 Brief reports Heat stability of the antimicrobial activity of sixty-two antibacterial agents Walter H. Traub and Birgit Leonhard Institut fur Medizinische

More information

AMR Industry Alliance Antibiotic Discharge Targets

AMR Industry Alliance Antibiotic Discharge Targets AMR Industry Alliance Antibiotic Discharge Targets List of Predicted No-Effect Concentrations (PNECs) The members of the AMR Industry Alliance have developed a unified approach to establishing discharge

More information

ESCMID Online Lecture Library. by author

ESCMID Online Lecture Library. by author Quality Assurance of antimicrobial susceptibility testing Derek Brown EUCAST Scientific Secretary ESCMID Postgraduate Education Course, Linz, 17 September 2014 Quality Assurance The total process by which

More information

Compliance of manufacturers of AST materials and devices with EUCAST guidelines

Compliance of manufacturers of AST materials and devices with EUCAST guidelines Compliance of manufacturers of AST materials and devices with EUCAST guidelines Data are based on questionnaires to manufacturers of materials and devices for antimicrobial susceptibility testing. The

More information

British Society for Antimicrobial Chemotherapy

British Society for Antimicrobial Chemotherapy British Society for Antimicrobial Chemotherapy BSAC to actively support the EUCAST Disc Diffusion Method for Antimicrobial Susceptibility Testing in preference to the current BSAC Disc Diffusion Method

More information

GENERAL NOTES: 2016 site of infection type of organism location of the patient

GENERAL NOTES: 2016 site of infection type of organism location of the patient GENERAL NOTES: This is a summary of the antibiotic sensitivity profile of clinical isolates recovered at AIIMS Bhopal Hospital during the year 2016. However, for organisms in which < 30 isolates were recovered

More information

The Very Latest from the CLSI AST Subcommittee.

The Very Latest from the CLSI AST Subcommittee. 2 0 1 4 The Very Latest from the CLSI AST Subcommittee. Susan E. Sharp, Ph.D., DABMM, FAAM Director - Regional Laboratory Director - Regional Microbiology/Molecular Infectious Diseases Diagnostics Laboratory

More information

British Society for Antimicrobial Chemotherapy

British Society for Antimicrobial Chemotherapy British Society for Antimicrobial Chemotherapy Standing Committee on Susceptibility Testing Version 13.0, 10-06-2014 Content Page Additional information Changes in version 13 2 Suggestions for appropriate

More information

MICRONAUT MICRONAUT-S Detection of Resistance Mechanisms. Innovation with Integrity BMD MIC

MICRONAUT MICRONAUT-S Detection of Resistance Mechanisms. Innovation with Integrity BMD MIC MICRONAUT Detection of Resistance Mechanisms Innovation with Integrity BMD MIC Automated and Customized Susceptibility Testing For detection of resistance mechanisms and specific resistances of clinical

More information

EUCAST Expert Rules for Staphylococcus spp IF resistant to isoxazolylpenicillins

EUCAST Expert Rules for Staphylococcus spp IF resistant to isoxazolylpenicillins EUAST Expert Rules for 2018 Organisms Agents tested Agents affected Rule aureus Oxacillin efoxitin (disk diffusion), detection of meca or mec gene or of PBP2a All β-lactams except those specifically licensed

More information

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Antibiotic Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Any substance of natural, synthetic or semisynthetic origin which at low concentrations kills or inhibits the growth of bacteria

More information

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults National Clinical Guideline Centre Antibiotic classifications Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults Clinical guideline 191 Appendix N 3 December 2014

More information

BSAC standardized disc susceptibility testing method (version 8)

BSAC standardized disc susceptibility testing method (version 8) Journal of Antimicrobial Chemotherapy (2009) 64, 454 489 doi:10.1093/jac/dkp244 Advance Access publication 8 July 2009 BSAC standardized disc susceptibility testing method (version 8) J. M. Andrews* for

More information

SMART WORKFLOW SOLUTIONS Introducing DxM MicroScan WalkAway System* ...

SMART WORKFLOW SOLUTIONS Introducing DxM MicroScan WalkAway System* ... SMART WORKFLOW SOLUTIONS Introducing DxM MicroScan WalkAway System* The next-generation MicroScan WalkAway System combines proven technology and reliability with enhanced ease-of-use features to streamline

More information

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review

21 st Expert Committee on Selection and Use of Essential Medicines Peer Review Report Antibiotics Review (1) Have all important studies/evidence of which you are aware been included in the application? Yes No Please provide brief comments on any relevant studies that have not been included: (2) For each of

More information

Background and Plan of Analysis

Background and Plan of Analysis ENTEROCOCCI Background and Plan of Analysis UR-11 (2017) was sent to API participants as a simulated urine culture for recognition of a significant pathogen colony count, to perform the identification

More information

Intrinsic, implied and default resistance

Intrinsic, implied and default resistance Appendix A Intrinsic, implied and default resistance Magiorakos et al. [1] and CLSI [2] are our primary sources of information on intrinsic resistance. Sanford et al. [3] and Gilbert et al. [4] have been

More information

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016 Mercy Medical Center Des Moines, Iowa Department of Pathology Microbiology Department Antibiotic Susceptibility January December 2016 These statistics are intended solely as a GUIDE to choosing appropriate

More information

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California

More information

Update on the CLSI Standards for Antimicrobial Susceptibility Testing: What s New with the Gram Positive Organisms?

Update on the CLSI Standards for Antimicrobial Susceptibility Testing: What s New with the Gram Positive Organisms? 2 0 1 3 CASES (with answers!) Update on the CLSI Standards for Antimicrobial Susceptibility Testing: What s New with the Gram Positive Organisms? Susan E. Sharp, Ph.D., DABMM, FAAM Director - Regional

More information

EUCAST-and CLSI potency NEO-SENSITABS

EUCAST-and CLSI potency NEO-SENSITABS EUCASTand CLSI potency NEOSENSITABS Neo Sensitabs Page 1 / 6 Document: 6.2.0 Fastidious organisms EUCAST Interpretation zones and MIC breakpoints according to recommendations by the "Comité de l'antibiogramme

More information

Childrens Hospital Antibiogram for 2012 (Based on data from 2011)

Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Prepared by: Department of Clinical Microbiology, Health Sciences Centre For further information contact: Andrew Walkty, MD, FRCPC Medical

More information

Concise Antibiogram Toolkit Background

Concise Antibiogram Toolkit Background Background This toolkit is designed to guide nursing homes in creating their own antibiograms, an important tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions

More information

SAMPLE VET08. Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated From Animals.

SAMPLE VET08. Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated From Animals. VET08 4th Edition Performance Standards for Antimicrobial Disk and Dilution Susceptibility Tests for Bacteria Isolated From Animals This document includes updated tables for the Clinical and Laboratory

More information

Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance. evolution of antimicrobial resistance

Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance. evolution of antimicrobial resistance Chemotherapy of bacterial infections. Part II. Mechanisms of Resistance evolution of antimicrobial resistance Mechanism of bacterial genetic variability Point mutations may occur in a nucleotide base pair,

More information

Helen Heffernan and Rosemary Woodhouse Antibiotic Reference Laboratory

Helen Heffernan and Rosemary Woodhouse Antibiotic Reference Laboratory METHODS USED IN NEW ZEALAND DIAGNOSTIC LABORATORIES TO IDENTIFY AND REPORT EXTENDED-SPECTRUM β-lactamase- PRODUCING ENTEROBACTERIACEAE by Helen Heffernan and Rosemary Woodhouse Antibiotic Reference Laboratory

More information

Version 1.01 (01/10/2016)

Version 1.01 (01/10/2016) CHN58: ANTIMICROBIAL SUSCEPTIBILITY TESTING (CLSI) 1.0 PURPOSE / INTRODUCTION: 1.1 Introduction Antimicrobial susceptibility tests are performed in order to determine whether a pathogen is likely to be

More information

Antimicrobial Susceptibility Patterns

Antimicrobial Susceptibility Patterns Antimicrobial Susceptibility Patterns KNH SURGERY Department Masika M.M. Department of Medical Microbiology, UoN Medicines & Therapeutics Committee, KNH Outline Methodology Overall KNH data Surgery department

More information

Evaluation of the BIOGRAM Antimicrobial Susceptibility Test System

Evaluation of the BIOGRAM Antimicrobial Susceptibility Test System JOURNAL OF CLINICAL MICROBIOLOGY, Nov. 1985, p. 793-798 0095-1137/85/110793-06$02.00/0 Copyright 1985, American Society for Microbiology Vol. 22, No. 5 Evaluation of the BIOGRAM Antimicrobial Susceptibility

More information

Streptococcus pneumoniae. Oxacillin 1 µg as screen for beta-lactam resistance

Streptococcus pneumoniae. Oxacillin 1 µg as screen for beta-lactam resistance Streptococcus pneumoniae Oxacillin µg as screen for beta-lactam resistance Version 6. June Streptococcus pneumoniae and zone diameter correlates The following histograms present inhibition zone diameter

More information

Antibiotic Updates: Part II

Antibiotic Updates: Part II Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures

More information

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine 2012 ANTIBIOGRAM Central Zone Former DTHR Sites Department of Pathology and Laboratory Medicine Medically Relevant Pathogens Based on Gram Morphology Gram-negative Bacilli Lactose Fermenters Non-lactose

More information

2 0 hr. 2 hr. 4 hr. 8 hr. 10 hr. 12 hr.14 hr. 16 hr. 18 hr. 20 hr. 22 hr. 24 hr. (time)

2 0 hr. 2 hr. 4 hr. 8 hr. 10 hr. 12 hr.14 hr. 16 hr. 18 hr. 20 hr. 22 hr. 24 hr. (time) Key words I μ μ μ μ μ μ μ μ μ μ μ μ μ μ II Fig. 1. Microdilution plate. The dilution step of the antimicrobial agent is prepared in the -well microplate. Serial twofold dilution were prepared according

More information

Educating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges

Educating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges Educating Clinical and Public Health Laboratories About Antimicrobial Resistance Challenges Janet Hindler, MCLS MT(ASCP) UCLA Medical Center jhindler@ucla.edu also working as a consultant with the Association

More information

EAGAR Importance Rating and Summary of Antibiotic Uses in Humans in Australia

EAGAR Importance Rating and Summary of Antibiotic Uses in Humans in Australia EAGAR Importance Rating and Summary of Antibiotic Uses in Humans in Australia Background The Expert Advisory Group on Antimicrobial Resistance of the NH&MRC provides advice to Australian governments and

More information

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process Quality ID #116 (NQF 0058): Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis National Quality Strategy Domain: Efficiency and Cost Reduction 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY

More information

CAP Laboratory Improvement Programs. Performance Accuracy of Antibacterial and Antifungal Susceptibility Test Methods

CAP Laboratory Improvement Programs. Performance Accuracy of Antibacterial and Antifungal Susceptibility Test Methods CAP Laboratory Improvement Programs Performance Accuracy of Antibacterial and Antifungal usceptibility Test Methods Report From the College of American Pathologists Microbiology urveys Program (001 003)

More information

STAPHYLOCOCCI: KEY AST CHALLENGES

STAPHYLOCOCCI: KEY AST CHALLENGES Romney Humphries, PhD D(ABMM) Section Chief, UCLA Clinical Microbiology Los Angeles CA rhumphries@mednet.ucla.edu STAPHYLOCOCCI: KEY AST CHALLENGES THE CHALLENGES detection of penicillin resistance detection

More information

STAPHYLOCOCCI: KEY AST CHALLENGES

STAPHYLOCOCCI: KEY AST CHALLENGES Romney Humphries, PhD D(ABMM) Section Chief, UCLA Clinical Microbiology Los Angeles CA rhumphries@mednet.ucla.edu STAPHYLOCOCCI: KEY AST CHALLENGES THE CHALLENGES detection of penicillin resistance detection

More information

Should we test Clostridium difficile for antimicrobial resistance? by author

Should we test Clostridium difficile for antimicrobial resistance? by author Should we test Clostridium difficile for antimicrobial resistance? Paola Mastrantonio Department of Infectious Diseases Istituto Superiore di Sanità, Rome,Italy Clostridium difficile infection (CDI) (first

More information

Taiwan Surveillance of Antimicrobial Resistance (TSAR)

Taiwan Surveillance of Antimicrobial Resistance (TSAR) Taiwan Surveillance of Antimicrobial Resistance (TSAR) 2009 MIRL Symposium July 17, 2009 Tsai-Ling Yang Lauderdale ( ) Microbial Infections Reference Laboratory (MIRL) Division of Infectious Diseases,

More information

Int.J.Curr.Microbiol.App.Sci (2018) 7(8):

Int.J.Curr.Microbiol.App.Sci (2018) 7(8): International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 08 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.708.378

More information

Defining Resistance and Susceptibility: What S, I, and R Mean to You

Defining Resistance and Susceptibility: What S, I, and R Mean to You Defining Resistance and Susceptibility: What S, I, and R Mean to You Michael D. Apley, DVM, PhD, DACVCP Department of Clinical Sciences College of Veterinary Medicine Kansas State University Susceptible

More information

Quality assurance of antimicrobial susceptibility testing

Quality assurance of antimicrobial susceptibility testing Quality assurance of antimicrobial susceptibility testing Derek Brown Routine quality control Repeated testing of controls in parallel with tests to ensure that the test system is performing reproducibly

More information

Volume-7, Issue-2, April-June-2016 Coden IJABFP-CAS-USA Received: 5 th Mar 2016 Revised: 11 th April 2016 Accepted: 13 th April 2016 Research article

Volume-7, Issue-2, April-June-2016 Coden IJABFP-CAS-USA Received: 5 th Mar 2016 Revised: 11 th April 2016 Accepted: 13 th April 2016 Research article Volume-7, Issue-2, April-June-2016 Coden IJABFP-CAS-USA Copyrights@2016 Received: 5 th Mar 2016 Revised: 11 th April 2016 Accepted: 13 th April 2016 Research article A STUDY ON ANTIBIOTIC SUSCEPTIBILITY

More information

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 The β- Lactam Antibiotics Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 Penicillins. Cephalosporins. Carbapenems. Monobactams. The β- Lactam Antibiotics 2 3 How

More information

Lab Exercise: Antibiotics- Evaluation using Kirby Bauer method.

Lab Exercise: Antibiotics- Evaluation using Kirby Bauer method. Lab Exercise: Antibiotics- Evaluation using Kirby Bauer method. OBJECTIVES 1. Compare the antimicrobial capabilities of different antibiotics. 2. Compare effectiveness of with different types of bacteria.

More information

Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how?

Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how? Einheit für pädiatrische Infektiologie Antibiotics - what, why, when and how? Andrea Duppenthaler andrea.duppenthaler@insel.ch Limping patient local pain swelling tenderness warmth fever acute Osteomyelitis

More information

Detection of Methicillin Resistant Strains of Staphylococcus aureus Using Phenotypic and Genotypic Methods in a Tertiary Care Hospital

Detection of Methicillin Resistant Strains of Staphylococcus aureus Using Phenotypic and Genotypic Methods in a Tertiary Care Hospital International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 7 (2017) pp. 4008-4014 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.607.415

More information

Understanding the Hospital Antibiogram

Understanding the Hospital Antibiogram Understanding the Hospital Antibiogram Sharon Erdman, PharmD Clinical Professor Purdue University College of Pharmacy Infectious Diseases Clinical Pharmacist Eskenazi Health 5 Understanding the Hospital

More information

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2017 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

Interpreting Microbiology reports for better Clinical Decisions Interpreting Antibiogrammes

Interpreting Microbiology reports for better Clinical Decisions Interpreting Antibiogrammes Interpreting Microbiology reports for better Clinical Decisions Interpreting Antibiogrammes Prof C. Wattal Hon. Sr. Consultant & Chairman Dept. of Clinical Microbiology Sir Ganga Ram Hospital New Delhi

More information

Chapter 2. Disk diffusion method

Chapter 2. Disk diffusion method Chapter 2. Disk diffusion method Tendencia, Eleonor A. Date published: 2004 To cite this document : Tendencia, E. A. (2004). Chapter 2. Disk diffusion method. In Laboratory manual of standardized methods

More information

Available online at ISSN No:

Available online at  ISSN No: Available online at www.ijmrhs.com ISSN No: 2319-5886 International Journal of Medical Research & Health Sciences, 2017, 6(4): 36-42 Comparative Evaluation of In-Vitro Doripenem Susceptibility with Other

More information

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018

Antimicrobial Update. Alison MacDonald Area Antimicrobial Pharmacist NHS Highland April 2018 Antimicrobial Update Alison MacDonald Area Antimicrobial Pharmacist NHS Highland alisonc.macdonald@nhs.net April 2018 Starter Questions Setting the scene... What if antibiotics were no longer effective?

More information

THE NAC CHALLENGE PANEL OF ISOLATES FOR VERIFICATION OF ANTIBIOTIC SUSCEPTIBILITY TESTING METHODS

THE NAC CHALLENGE PANEL OF ISOLATES FOR VERIFICATION OF ANTIBIOTIC SUSCEPTIBILITY TESTING METHODS THE NAC CHALLENGE PANEL OF ISOLATES FOR VERIFICATION OF ANTIBIOTIC SUSCEPTIBILITY TESTING METHODS Stefanie Desmet University Hospitals Leuven Laboratory medicine microbiology stefanie.desmet@uzleuven.be

More information

Antimicrobial Resistance Strains

Antimicrobial Resistance Strains Antimicrobial Resistance Strains Microbiologics offers a wide range of strains with characterized antimicrobial resistance mechanisms including: Extended-Spectrum β-lactamases (ESBLs) Carbapenamases Vancomycin-Resistant

More information

Cell Wall Weakeners. Antimicrobials: Drugs that Weaken the Cell Wall. Bacterial Cell Wall. Bacterial Resistance to PCNs. PCN Classification

Cell Wall Weakeners. Antimicrobials: Drugs that Weaken the Cell Wall. Bacterial Cell Wall. Bacterial Resistance to PCNs. PCN Classification Cell Wall Weakeners Antimicrobials: Drugs that Weaken the Cell Wall Beta Lactams Penicillins Cephalosporins Carbapenems Aztreonam Vancomycin Teicoplanin Bacterial Cell Wall Bacterial cytoplasm is hypertonic

More information

Approach to pediatric Antibiotics

Approach to pediatric Antibiotics Approach to pediatric Antibiotics Gassem Gohal FAAP FRCPC Assistant professor of Pediatrics objectives To be familiar with common pediatric antibiotics o Classification o Action o Adverse effect To discus

More information

Prevalence of Extended Spectrum Beta- Lactamase Producers among Various Clinical Samples in a Tertiary Care Hospital: Kurnool District, India

Prevalence of Extended Spectrum Beta- Lactamase Producers among Various Clinical Samples in a Tertiary Care Hospital: Kurnool District, India International Journal of Current Microbiology and Applied Sciences ISSN: 319-77 Volume Number (17) pp. 57-3 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/1.5/ijcmas.17..31

More information

Quality ID #66: Appropriate Testing for Children with Pharyngitis National Quality Strategy Domain: Efficiency and Cost Reduction

Quality ID #66: Appropriate Testing for Children with Pharyngitis National Quality Strategy Domain: Efficiency and Cost Reduction Quality ID #66: Appropriate Testing for Children with Pharyngitis National Quality Strategy Domain: Efficiency and Cost Reduction 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Process

More information

Antibiotic Susceptibility of Common Bacterial Pathogens in Canine Urinary Tract Infections

Antibiotic Susceptibility of Common Bacterial Pathogens in Canine Urinary Tract Infections Vol.1 No.2 Oct-Dec 2013 ISSN : 2321-6387 Antibiotic Susceptibility of Common Bacterial Pathogens in Canine Urinary Tract Infections S. Yogeshpriya*, Usha N.Pillai, S. Ajithkumar and N. Madhavan Unny Department

More information

ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat

ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat Hicham Ezzat Professor of Microbiology and Immunology Cairo University Introduction 1 Since the 1980s there have been dramatic

More information

Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems

Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems Micro 301 Antimicrobial Drugs 11/7/12 Significance of antimicrobial drugs Challenges Emerging resistance Fewer new drugs MRSA and other resistant pathogens are major problems Definitions Antibiotic Selective

More information

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2016 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

Antimicrobial susceptibility

Antimicrobial susceptibility Antimicrobial susceptibility PATTERNS Microbiology Department Canterbury ealth Laboratories and Clinical Pharmacology Department Canterbury District ealth Board March 2011 Contents Preface... Page 1 ANTIMICROBIAL

More information

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient

1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient 1 Chapter 79, Self-Assessment Questions 1. The preferred treatment option for an initial UTI episode in a 22-year-old female patient with normal renal function is: A. Trimethoprim-sulfamethoxazole B. Cefuroxime

More information

Int.J.Curr.Microbiol.App.Sci (2017) 6(11):

Int.J.Curr.Microbiol.App.Sci (2017) 6(11): International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 11 (2017) pp. 2293-2299 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.611.272

More information

RESISTANCE OF STAPHYLOCOCCUS AUREUS TO VANCOMYCIN IN ZARQA, JORDAN

RESISTANCE OF STAPHYLOCOCCUS AUREUS TO VANCOMYCIN IN ZARQA, JORDAN RESISTANCE OF STAPHYLOCOCCUS AUREUS TO VANCOMYCIN IN ZARQA, JORDAN Hussein Azzam Bataineh 1 ABSTRACT Background: Vancomycin has been widely used in the treatment of infections caused by Methicillin-Resistant

More information

Mechanism of antibiotic resistance

Mechanism of antibiotic resistance Mechanism of antibiotic resistance Dr.Siriwoot Sookkhee Ph.D (Biopharmaceutics) Department of Microbiology Faculty of Medicine, Chiang Mai University Antibiotic resistance Cross-resistance : resistance

More information

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services 2015 Antibiogram Red Deer Regional Hospital Central Zone Alberta Health Services Introduction. This antibiogram is a cumulative report of the antimicrobial susceptibility rates of common microbial pathogens

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXIX NUMBER 3 November 2014 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell SM MLS (ASCP), Marti Roe SM MLS (ASCP), Sarah Parker MD, Jason Child PharmD, and Samuel R.

More information

Antibiotics. Antimicrobial Drugs. Alexander Fleming 10/18/2017

Antibiotics. Antimicrobial Drugs. Alexander Fleming 10/18/2017 Antibiotics Antimicrobial Drugs Chapter 20 BIO 220 Antibiotics are compounds produced by fungi or bacteria that inhibit or kill competing microbial species Antimicrobial drugs must display selective toxicity,

More information

Penicillins - EUCAST clinical MIC breakpoints (version 1.3)

Penicillins - EUCAST clinical MIC breakpoints (version 1.3) EUCAST clinical MIC breakpoints - penicillins Penicillins - EUCAST clinical MIC breakpoints 2009-04-19 (version 1.3) Penicillins Click on antibiotic name to see wild type MIC distributions. Enterobacteriaceae

More information

Comparative Assessment of b-lactamases Produced by Multidrug Resistant Bacteria

Comparative Assessment of b-lactamases Produced by Multidrug Resistant Bacteria Comparative Assessment of b-lactamases Produced by Multidrug Resistant Bacteria Juhee Ahn Department of Medical Biomaterials Engineering Kangwon National University October 23, 27 Antibiotic Development

More information

ENTEROCOCCI. April Abbott Deaconess Health System Evansville, IN

ENTEROCOCCI. April Abbott Deaconess Health System Evansville, IN ENTEROCOCCI April Abbott Deaconess Health System Evansville, IN OBJECTIVES Discuss basic antimicrobial susceptibility principles and resistance mechanisms for Enterococcus Describe issues surrounding AST

More information

APPENDIX III - DOUBLE DISK TEST FOR ESBL

APPENDIX III - DOUBLE DISK TEST FOR ESBL Policy # MI\ANTI\04\03\v03 Page 1 of 5 Section: Antimicrobial Susceptibility Testing Manual Subject Title: Appendix III - Double Disk Test for ESBL Issued by: LABORATORY MANAGER Original Date: January

More information