EUCAST recommended strains for internal quality control

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EUCAST recommended strains for internal quality control Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus influenzae ATCC 59 ATCC 785 ATCC 91 ATCC 91 ATCC 9619 NCTC 868 1 Version number Strain Changes 1.1, 009-09-6 ATCC 91 Erythromycin corrected from to 15 μg and ciprofloxacin from 0 to 5 μg. 1., 010-0-7 ATCC 59 QC ranges updated : Cefadroxil, doripenem and nitrofurantoin. Antibiotics added: Amoxicillin, ampicillin-sulbactam, cefalexin, cefixime, ceftriaxone, colistin, fosfomycin, levofloxacin, netilmicin, ofloxacin, piperacillin, ticarcillin and ticarcillin-clavulanic acid. ATCC 785 ATCC 91 ATCC 91 ATCC 9619 NCTC 868 Antibiotics removed : Cefoxitin and tetracycline. QC ranges updated : Doripenem Antibiotics added: Colistin, fosfomycin, levofloxacin, netilmicin, piperacillin, ticarcillin and ticarcillin-clavulanic acid. QC ranges updated : Moxifloxacin and vancomycin (only ranges for vancomycin). Antibiotics added: Azithromycin, clarithromycin, daptomycin, doxycycline, fosfomycin, levofloxacin, minocycline, netilmicin, ofloxacin, quinupristindalfopristin and teicoplanin. Antibiotics removed : Amoxicillin-clavulanic acid, cefepime, cefotaxime, cefpodoxime, cefuroxime, ertapenem, meropenem, oxacillin and piperacillin-tazobactam. Antibiotics added: Quinupristin-dalfopristin. Antibiotics removed : Amoxicillin-clavulanic acid, chloramphenicol, ciprofloxacin, erythromycin, moxifloxacin, norfloxacin, piperacillintazobactam, rifampicin and tobramycin. QC ranges updated : Tetracycline (zone) and linezolid (). Azithromycin and clarithromycin (only ranges). Antibiotics added: Benzylpenicillin, ciprofloxacin, daptomycin, doxycycline, minocycline, teicoplanin and telithromycin. Antibiotics removed : Piperacillin-tazobactam. QC ranges updated : Trimethoprim-sulfamethoxazole Antibiotics added: Amoxicillin, ampicillin-sulbactam, minocycline and telithromycin. Antibiotics removed : Azithromycin, aztreonam, clarithromycin, piperacillin-tazobactam and tigecycline. 1 NCTC 868 is susceptible to beta-lactam antibiotics and easier to read on MH-F than the commonly recommended ATCC 97 which is a BLNAR with variable inhibition zones for beta-lactam antibiotics. Updated by EUCAST and/or CLSI. Antibiotics not in EUCAST Clinical Breakpoint Table or no data for ranges.

Escherichia coli ATCC 59 (NCTC 11, CIP 76., DSM 110, CCUG 1760) Mueller-Hinton agar, McFarland 0.5, air, 5±1ºC, 18±h. Read zone edges as the point showing Target 1 Range Target 1 Range Amikacin 1-0.5-0 19-6 Amoxicillin 8-16 10 IP IP Amoxicillin-clavulanic acid / /1-8/ 0-10 1 18- Ampicillin -8 10 19 16- Ampicillin-sulbactam / /1-8/ 10-10 19- Aztreonam 0.1 0.06-0.5 0 8-6 Cefadroxil - - 0 17 1-0 Cefalexin - - 0 IP IP Cefepime 0.0-0.06 0.015-0.1 0 1-7 Cefixime 0.5 0.5-1 5 5-7 Cefotaxime 0.06 0.0-0.1 5 8 5-1 Cefpodoxime 0.5 0.5-1 10 6-8 Ceftazidime 0.1-0.5 0.06-0.5 10 6-9 Ceftibuten 0.5 0.1-0.5 0 1 7-5 Ceftriaxone 0.06 0.0-0.1 0 9-5 Cefuroxime -8 0 0-6 Chloramphenicol -8 0 1-7 Ciprofloxacin 0.008 0.00-0.015 5 5 0-0 Colistin 1 0.5- - - - Doripenem 0.0 0.015-0.06 10 1 7-5 Fosfomycin 5 1 0.5- - - - Ertapenem 0.008 0.00-0.015 10 9-6 Gentamicin 0.5 0.5-1 10 19-6 Imipenem 0.1 0.06-0.5 10 9 6- Levofloxacin 0.015-0.0 0.008-0.06 5 9-7 Mecillinam 0.06-0.1 0.0-0.5 10 7-0 Meropenem 0.015-0.0 0.008-0.06 10 1 8- Moxifloxacin 0.015-0.0 0.008-0.06 5 8-5 Nalidixic acid 1-0 5-8 Netilmicin - 0.5-1 10 IP IP Nitrofurantoin 8-16 100 0 17- Norfloxacin 0.06 0.0-0.1 10 8-5 Ofloxacin 0.0-0.06 0.015-0.1 5 1 9- Piperacillin 1-0 1-7 Piperacillin-tazobactam / 1/-/ 0-6 1-7 Ticarcillin 8-16 75 7-0 Ticarcillin-clavulanic acid 8/ /-16/ 75-10 7-0 Tigecycline 5 0.1 0.0-0.5 15 0-7 Tobramycin 0.5 0.5-1 10 18-6 Trimethoprim 1 0.5-5 5 1-8 Trimethoprim-sulfamethoxazole 0.5/9.5-1.5-.75 6-9 International Standard ISO 0776-1: 006. Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010. (Data in bold/italics from repeated testing by EUCAST. Inhibition zone diameters were measured on at least 0 different occasions on more than five batches of Mueller-Hinton agar from several manufacturers.) Ignore growth that may appear as a thin inner zone with ampicillin on some batches of Mueller-Hinton agars. 5 For test conditions, see Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010.

Pseudomonas aeruginosa ATCC 785 (NCTC 190, CIP 76.110, DSM 1117, CCUG 17619) Mueller-Hinton agar, McFarland 0.5, air, 5±1ºC, 18±h. Read zone edges as the point showing Target 1 Range Target 1 Range Amikacin 1-0 18-6 Aztreonam -8 0 6-9 Cefepime - 1-8 0 7-0 Ceftazidime 1-10 1-7 Ciprofloxacin 0.5 0.5-1 5 9 5- Colistin 1-0.5- - - - Doripenem 0,5 0.1-0.5 10 8-5 Fosfomycin -8 - - - Gentamicin 1 0.5-10 19 16-1 Imipenem 1-10 0-8 Levofloxacin 1-0.5-5 19-6 Meropenem 0.5 0.5-1 10 0 7- Netilmicin 0.5-8 10 18 15-1 Piperacillin - 1-8 - - - Piperacillin-tazobactam -/ 1/-8/ 0-6 6-9 Ticarcillin 16 8- - - - Ticarcillin-clavulanic acid 16/ 8/-/ 75-10 0-8 Tobramycin 0.5 0.5-1 10 19-5 International Standard ISO 0776-1: 006. Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010. (Data in bold/italics from repeated testing by EUCAST. Inhibition zone diameters were measured on at least 0 different occasions on more than five batches of Mueller-Hinton agar from several manufacturers.) For test conditions, see Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010.

Staphylococcus aureus ATCC 91* (NCTC 197, CIP 109, DSM 569, CCUG 15915) * β-lactamase-producing strain (weak) Mueller-Hinton agar, McFarland 0.5, air, 5±1ºC, 18±h. Read zone edges as the point showing Target 1 Range Target 1 Range Amikacin 1-0 1 18- Azithromycin 1 0.5- - - - Benzylpenicillin - - 1 unit 15 1-18 Cefoxitin 1-0 7-0 Chloramphenicol -8-16 0 0-8 Ciprofloxacin 0,5 0.1-0.5 5 1-7 Clarithromycin 0,5 0.1-0.5 - - - Clindamycin 0,1 0.06-0.5 6-9 Daptomycin 0.5-0.5 0.1-1 - - - Doxycycline 0,5 0.1-0.5 - - - Erythromycin 0,5 0.5-1 15 6-9 Fosfomycin 1-0.5- - - - Fusidic acid 0,1 0.06-0.5 10 9 6- Gentamicin 0.5-0.5 0.1-1 10 19-5 Levofloxacin 0.1-0.5 0.06-0.5 5 IP IP Linezolid 1-10 1-7 Minocycline 0.1-0.5 0.06-0.5 0 IP IP Moxifloxacin 0.0-0.06 0.015-0.1 5 8 5-1 Netilmicin 0.5-10 0-6 Nitrofurantoin 16 8-100 0 17- Norfloxacin 1 0.5-10 1 18- Ofloxacin 0.5-0.5 0.1-1 5 1-7 Quinupristin-dalfopristin 0,5 0.5-1 15 IP IP Rifampicin 0,008 0.00-0.015 5 0-6 Teicoplanin 0,5 0.5-1 - - - Tetracycline 0.5-0.5 0.1-1 0 7-1 Tigecycline 0.06-0.1 0.0-0.5 15 19-5 Tobramycin 0.5-0.5 0.1-1 10 0-6 Trimethoprim 1-5 5-8 Trimethoprim-sulfamethoxazole 0.5/9.5-1.5-.75 9 6- Vancomycin 1 0.5- - - - International Standard ISO 0776-1: 006. Data in bold/italics from repeated testing by EUCAST. Inhibition zone diameters were measured on at least 0 For test conditions, see Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010.

Enterococcus faecalis ATCC 91 (NCTC 1697, CIP 101, DSM 570, CCUG 9997) Mueller-Hinton agar, McFarland 0.5, air, 5±1ºC, 18±h. Read zone edges as the point showing Target 1 Range Target 1 Range Ampicillin 1 0.5-18 15-1 Gentamicin 8-16 0 15 1-18 Imipenem 1 0.5-10 7-0 Linezolid 1-10 19-5 Nitrofurantoin 8-16 100 1 18- Quinupristin-dalfopristin -8 15 1 11-17 Teicoplanin 0,1 0.06-0.5 0 18 15-1 Tetracycline 16 8-0 1 10-16 Tigecycline 5 0,06 0.0-0.1 15 0-6 Trimethoprim 1-5 8 - Trimethoprim-sulfamethoxazole 0.5/9.5-1.5-.75 0 6- Vancomycin 1-5 1 10-16 International Standard ISO 0776-1: 006. Data in bold/italics from repeated testing by EUCAST. Inhibition zone diameters were measured on at least 0 Screening disk for high-level aminoglycoside-resistance in enterococci. 5 For test conditions, see Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010.

Streptococcus pneumoniae ATCC 9619*/** (NCTC 1977, CIP 100, DSM 11967, CCUG 68) * Penicillin-intermediate strain ** Zone edges for S. pneumoniae on MH-F may be accompanied by α-haemolysis extending approximately 1 mm into the zone. Read growth, not haemolysis. With some batches of agar and some antibiotics the colonies at the zone edge lyse and the apparent width of haemolysis is considerably greater. The zone edge should be read as the edge of the lysed colonies indicated by a haze just inside the α-haemolysis. Mueller-Hinton agar + 5% horse blood and 0 mg/l β-nad, McFarland 0.5, 5% CO, 5±1ºC, 18±h. Read zone edges as the point showing no growth from the front with the lid removed and reflected light. Target 1 Range Target 1 Range Ampicillin 0,1 0.06-0.5 8 5-1 Azithromycin 0,1 0.06-0.5 - - - Benzylpenicillin 0,5 0.5-1 1 unit 18 15-1 Cefaclor 1-0 8 5-1 Cefepime 0.06-0.1 0.0-0.5 0 1-7 Cefotaxime 0,06 0.0-0.1 5 1 8- Cefpodoxime 0,06 0.0-0.1 10 9-5 Ceftriaxone 0,06 0.0-0.1 0 5-8 Cefuroxime 0,5 0.5-1 0 1 8- Chloramphenicol -8 0 7-0 Ciprofloxacin - - 5 5-8 Clarithromycin 0,06 0.0-0.1 - - - Clindamycin 0,06 0.0-0.1 5-8 Daptomycin 5 0.1-0.5 0.06-0.5 - - - Doripenem 0,06 0.0-0.1 10 1-7 Doxycycline 0.0-0.06 0.015-0.1 - - - Ertapenem 0.06-0.1 0.0-0.5 10 1 8- Erythromycin 0,06 0.0-0.1 15 9 6- Imipenem 0,06 0.0-0.1 10 8 - Levofloxacin 1 0.5-5 1-7 Linezolid 0.5-1 0.5-10 6-9 Meropenem 0,1 0.06-0.5 10 0-8 Minocycline - - 0 8 5-1 Moxifloxacin 0,1 0.06-0.5 5 7-0 Norfloxacin -8 10 1 18- Ofloxacin 1-5 1 18- Oxacillin - - 1 11 8-1 Rifampicin 0,0 0.015-0.06 5 9 6- Teicoplanin - - 0 1 18- Telithromycin 0.008-0.016 0.00-0.0 15 0 7- Tetracycline 0,5 0.1-0.5 0 1 8- Tigecycline 5 0.0-0.06 0.015-0.1 15 7-0 Trimethoprim-sulfamethoxazole 0.5/.75-0.5/9.5 0.1/.-1/19 1.5-.75 0-6 Vancomycin 0,5 0.1-0.5 5 0 17- International Standard ISO 0776-1: 006. Data in bold/italics from repeated testing by EUCAST. Inhibition zone diameters were measured on at least 0 Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010. 5 For test conditions, see Clinical and Laboratory Standards Institute, M100-S0: 0:1, 010.

Haemophilus influenzae NCTC 868 (CIP 5.9, CCUG 96) Mueller-Hinton agar + 5% horse blood and 0 mg/l β-nad, McFarland 0.5, 5% CO, 5±1ºC, 18±h. Read zone edges as the point showing no growth from the front with the lid removed and reflected light. Target Range Target 1 Range 1 Amoxicillin IP IP 10 1-7 Amoxicillin-clavulanic acid IP IP 0-10 7-0 Ampicillin IP IP 19-5 Ampicillin-sulbactam IP IP 10-10 7-0 Cefaclor IP IP 0 7-0 Cefepime IP IP 0 9-5 Cefixime IP IP 5 0 7- Cefotaxime IP IP 5 9-5 Cefpodoxime IP IP 10 1 8- Ceftibuten IP IP 0 9-5 Ceftriaxone IP IP 0 7-1 Cefuroxime IP IP 0 8 5-1 Chloramphenicol IP IP 0 0-8 Ciprofloxacin IP IP 5 5 1-9 Doripenem IP IP 10 9 6- Ertapenem IP IP 10 0 7- Erythromycin IP IP 15 15 1-18 Imipenem IP IP 10 8 5-1 Levofloxacin IP IP 5 5-8 Meropenem IP IP 10 1 8- Minocycline IP IP 0 IP IP Moxifloxacin IP IP 5 9-5 Nalidixic acid IP IP 0 0 7- Ofloxacin IP IP 5 0-6 Phenoxymethylpenicillin IP IP 10 18 15-1 Rifampicin IP IP 5 0-6 Telithromycin IP IP 15 IP IP Tetracycline IP IP 0 1 8- Trimethoprim-sulfamethoxazole IP IP 1.5-.75 0 6- Data in bold/italics from repeated testing by EUCAST. Inhibition zone diameters were measured on at least 0