REVOLUTIONARY. Are recurrent bacterial infections a frustration in your practice? WE HAVE FOUND THE ANSWER. MMinimum inimizing BBiofilm EEradication C oncentration Concentration www.becscreen.com
WHY BIOFILM SUSCEPTIBILITY TESTING? With the advancement of antibiotics, bacteria have evolved out of sheer survival. While medicine has continued to make strides in this area, we have found ourselves at a place where we are playing catch up to the bacteria. Considering the extensive involvement of biofilms in infections and diseases in human (medicine), biofilms are responsible for a wide variety of infections in veterinary medicine. (Clutterbuck et al., 2007) New tools are required for the prevention, treatment and diagnosis of pathogens that form biofilms during the infection process, because biofilms have unique properties that are absent in planktonic cells. (Murphy et al., 2009) DID YOU KNOW? As many as 80% of infections are caused by Biofilms, hence the ineffectiveness of treating such chronic cases with MIC results alone. The becscreentm Antimicrobial Susceptibility Test provides insight to bacterial vulnerability above and beyond current MIC testing, analyzing the bacteria in its biofilm state. This groundbreaking technology is now available through Spectrum Labs. For the first time ever, this technology allows us to grow the bacteria in our lab in its Biofilm state rather than in a Planktonic state. This allows us to more effectively assess infections and provide antibiotic treatment to prevent these infections from coming back. Additionally, this assay also reduces antibiotic usage and future bacterial resistancy by allowing Veterinarians to utilize the correct antibiotics and dosage the first time.
IMPORTANT ANTIBIOTIC INFORMATION Our antibiotic panels have been developed over the course of several years to contain the most up to date and frequently used antibiotics in veterinary medicine. In the event any of our antibiotics become outdated or antiquated, we retain the ability to upgrade our panels at any time, thus ensuring you the highest quality results possible. Our most current antibiotic panels are: MBEC Gram Positive Antibiotics: Amoxicillin Ampicillin Azithromycin Cefazolin Cefovecin Cefpodoxime Ceftiofur Sodium Chloramphenicol Ciprofloxacin Clindamycin Doxycycline Enrofloxacin Erythromycin Gentamicin Sulfate Marbofloxacin Minocycline Orbifloxacin Oxacillin Sodium Rifampin Tetracycline Trimethoprim + Sulfamethoxazole Vancomycin (+) MBEC Gram Negative Antibiotics: Amikacin Amoxicillin + Clavulanate Ampicillin Azithromycin Cefazolin Cefovecin Cefpodoxime Ceftiofur Sodium Chloramphenicol Ciprofloxacin Doxycycline Enrofloxacin Gentamicin Sulfate Imipenem Marbofloxacin Minocycline Orbifloxacin Piperacillin Tetracycline Tobramycin Sulfate Ticarcillin Clavulanate Trimethoprim + Sulfamethoxazole ( - ) IMPROVED QUALITY OF LIFE FOR PETS contact us (800) 553-1391 www.becscreen.com
COMBINATION ANTIBIOTIC INFORMATION MBEC Gram Positive COMBINATION Antibiotics: Amoxicillin/Clavulanate + Linezolid Ampicillin/Sulbactam + Clindamycin Chloramphenicol + Enrofloxacin Chloramphenicol + Gentamicin Clindamycin + Ceftriaxone Doxycycline + Clindamycin Enrofloxacin + Doxycylcine Gentamicin + Amoxicillin/Clavulanate Gentamicin + Ampicillin/Sulbactam Gentamicin + Ceftriaxone Gentamicin + Clindamicin Gentamicin + Doxycycline Gentmaicin + Enrofloxacin Gentamicin + Linezolid Gentamicin + Marbofloxacin Gentamicin + Minocycline Linezolid + Doxycycline Linezolid + Marbofloxacin Marbofloxacin + Ampicillin/Sulbactam Marbofloxacin + Ceftriaxone Minocycline + Ampicillin/Sulbactam Minocycline + Ceftriaxone Minocycline + Enrofloxacin Trimethoprim/Sulfamethoxazole + Ampicillin/Sulbactam Trimethoprim/Sulfamethoxazole + Ceftriaxone Trimethoprim/Sulfamethoxazole + Clindamycin Trimethoprim/Sulfamethoxazole + Doxycycline Trimethoprim/Sulfamethoxazole + Enrofloxacin Trimethoprim/Sulfamethoxazole + Gentamicin Trimethoprim/Sulfamethoxazole + Linezolid Trimethoprim/Sulfamethoxazole + Marbofloxacin Trimethoprim/Sulfamethoxazole + Minocycline Vancomycin + Amoxicillin/Clavulanate Vancomycin + Ampicillin/Sulbactam Vancomycin + Gentamicin Chloramphenicol + Trimethoprim/Sulfamethoxazole Chloramphenicol + Linezolid Chloramphenicol + Clindamycin Chloramphenicol + Marbofloxacin Clindamycin + Vancomycin Clindamycin + Marbofloxacin Clindamycin + Enrofloxacin Clindamycin + Minocycline Cefovecin + Trimethoprim/Sulfamethoxazole Cefovecin + Linezolid Cefovecin + Clindamycin Cefovecin + Gentamicin (+) COMBINATION MBEC Gram Negative COMBINATION Antibiotics: Amoxicillin/Clavulanate + Azithromycin Amoxicillin/Clavulanate + Chloramphenicol Amoxicillin/Clavulanate + Orbifloxacin Amoxicillin/Clavulanate + Trimethoprim/Sulfamethoxazole Ampicillin + Azithromycin Ampicillin + Doxycycline Ampicillin + Minocycline Ampicillin + Orbifloxacin Ampicillin + Trimethoprim/Sulfamethoxazole Azithromycin + Imipenem Ceftazidime + Azithromycin Ceftazidime + Doxycycline Ceftazidime + Minocycline Ceftazidime + Orbifloxacin Ceftazidime + Trimethoprim/Sulfamethoxazole Chloramphenicol + Orbifloxacin Chloramphenicol + Trimethoprim/Sulfamethoxazole Doxycycline + Orbifloxacin Doxycycline + Trimethoprim/Sulfamethoxazole Gentamicin + Amoxicillin/Clavulanate Gentamicin + Ampicillin Gentamicin + Ceftazidime Gentamicin + Doxycycline Gentamicin + Imipenem Gentamicin + Minocycline Gentamicin + Orbifloxacin Gentamicin + Trimethoprim/Sulfamethoxazole Minocycline + Orbifloxacin Minocycline + Trimethoprim/Sulfamethoxazole Orbifloxacin + Imipenem Trimethoprim/Sulfamethoxazole + Azithromycin Trimethoprim/Sulfamethoxazole + Imipenem Trimethoprim/Sulfamethoxazole + Orbifloxacin Ceftazidime + Gentamicin + Orbifloxacin Imipenem + Gentamicin + Orbifloxacin ( - ) COMBINATION contact us (800) 553-1391 www.becscreen.com
2801 S. 35TH ST, PHOENIX, AZ 85034 (480) 464-8971 l (800) 553-1391 FAX: (480) 898-0611 BACTERIAL SUSCEPTIBILITY ORDER FORM www.becscreen.com Veterinarian: Specimen No: For Office Use Only: Date Rcvd: Clinic: Address: City: State Zip Phone: ( ) Fax: ( ) Email: Receive results via email within 7-10 days depending on growth pattern; full results booklet to follow via mail q Check Enclosed Animal s Name: Owner s Name: Breed: Age: q Bill on receipt of results Date: TESTING PANEL OPTIONS PLEASE CHECK APPROPRIATE BOX PLEASE NOTE: ACTIVE INFECTION REQUIRED; DISCONTINUE ANTIBIOTICS 7-10 DAYS PRIOR TO SWABBING. TOTAL COST MBEC PANEL (Minimum Biofilm Eradication Concentration) $60.00* Including ID/MIC for chronic recurring infections and combination antibiotic treatment options. per swab Please indicate which of the following antibiotics the patient has previously been treated with: q Amoxicillin q Ampicillin q Amikacin q Azithromycin q Cefazolin q Cefovecin q Cefpodoxime q Ceftiofur Sodium q Chloramphenicol q Ciprofloxacin q Clindamycin q Doxycycline q Enrofloxacin q Erythromycin q Gentamicin Sulfate q Imipenem q Marbofloxacin q Minocycline q Orbifloxacin q Oxacillin Sodium q Piperacillin q Rifampin q Sulfamethoxazole q Tetracycline q Ticarcillin Clavulanate q Tobramycin Sulfate q Trimethoprim q Vancomycin In the event there is no growth on any culture you will only be billed $30.00 Current as of 5.30.2014 form: BF2014
PATIENT HISTORY FORM Veterinarian: Animal s Name: Breed: Clinic: Owner s Name: Age: Date: 1. Where was the swab taken? q ear q skin q interdigital q urine q open wound q compound fracture q bone graft q gums q Other: 2. Please describe the condition of swab site (i.e. redness, swelling, etc). 3. Has any previous testing been done? If so where? When? 4. Has the patient ever received treatment? q yes q no, never treated 5. How long has this issue persisted? When was it first noticed? PLEASE NOTE: Active infection required; no antibiotics for 7-10 days prior to swabbing. 7. What, if any, symptoms have you noticed? 8. Additional Comments: When:
Submitting a SAMPLE: SAMPLES: Swab the infected area and store in the recommended transport media. PACKAGING: Once swab is placed in tube, package similarly to a serum sample (cotton balls to act as shock absorber, inside a sandwich or other sealable bag, etc). Make sure to include your submission paperwork (i.e. order and history form). Attach the provided 2-day pre-paid FedEx label and call FedEx to schedule a pickup (1.800.GO-FEDEX). STORAGE: Store bacteria in the refrigerator until you are ready to ship. It is not necessary to ship culture on ice. Interpreting RESULTS... Veterinary BioFilm Susceptibility Report Veterinary BioFilm Susceptibility Report Lab Number 2100172899 - M Patient Mayla Patry Order Date 10/30/2013 Strain ID 99.00% Staphylococcus pseudintermedius Gram Positive Breed Site Swab Clinic Name Veterinarian Pug Skin Clinique Veterinaire Vaudreuil Caroline Brazeau Lab Number 310047779 - M Patient Mystery Thriller Order Date 02/24/2012 Strain ID 95.00% Pseudomonas aeruginosa Sample ID 1220300 Breed Site Swab Clinic Name Veterinarian Standard Dermatitis BUCKEYE VETERINARY SERVICE Meghan Kartley Antibiotics SIR Breakpoints Minimum Inhibitory Minimum Biofilm Concentration Eradication Concentration (MIC) (MBEC) Amoxicillin S: 0.25, R: 0.5 >2 R >2 R Ampicillin S: 0.25, R: 0.5 Azithromycin S: 1, R: 2 >4 R >4 R Cefazolin S: 8,I: 16, R: 32 1 S >16 R Cefovecin S: 2, R: 4 1 S >8 R Cefpodoxime S: 2, I: 4, R: 8 2 S >16 R Ceftiofur S: 2, I: 4, R: 8 2 S 8 R Chloramphenicol S: 8, I: 16, R: 32 4 S >32 R Ciprofloxacin S: 1, I: 2, R: 4 1 S 1 S Clindamycin S: 0.5, I: 1-2, R: 4 >4 R >4 R Doxycycline S: 4, I: 8, R: 16 4 S >16 R Enrofloxacin S: 0.5, I: 1-2, R: 4 0.5 S 1 I Erythromycin S: 0.5, I: 1-2, R: 4 >8 R >8 R Gentamicin Sulfate S: 2, I: 4, R: 8 2 S 2 S Marbofloxacin S: 1, I: 2, R: 4 1 S >4 R Minocycline S: 4, I: 8, R: 16 4 S >16 R Orbifloxacin S: 1, I: 2-4, R: 8 1 S >8 R Oxacillin Sodium S: 0.25, R: 0.5 1 R 4 R Rifampin S: 1, I: 2, R: 4 1 S 1 S Tetracycline S: 4, I: 8, R: 16 Trimethoprim / Sulfamethoxazole S: 2/38, R: 4/76 4/76 R 4/76 R Vancomycin S: 2, I: 4-8, R: 16 2 S >32 R S: Susceptible I: Intermediate R: Resistant Veterinary Biofilm Susceptibility Testing is a qualitative, in-vitro diagnostic test designed for use in determining antimicrobial susceptibility of both planktonic and biofilm phenotypes of veterinary isolates. Minimum Inhibitory Concentration (MIC) results are for planktonic cells susceptibility and Minimum Biofilm Eradication Concentration (MBEC) results are for biofilms susceptibility. Results for each individual antibiotic may be applied to other antibiotics in the same class. Brought to you by The Spectrum Group (800)553-1391 FIGURE 1: These SAMPLE results indicate that there are 3 antibiotic options that can provide possible* treatment for the above infection in a biofilm state: Ciprofloxacin, Gentamiacin Sulfate, and Rifampin. The normal therapeutic dosage for a patient of this weight/size would be utilized, unless directed otherwise by your pharmacist or reference guide. Note the vast increase in suggested antibiotics using standard culture and sensitivity, In this case the patient could have been treated with 11 ineffective antibiotics. Antibiotics SIR Breakpoints Minimum Inhibitory Minimum Biofilm Concentration Eradication Concentration (MIC) (MBEC) Amikacin S: 16, I: 32, R: >32 >32 R >32 R Amikacin / Aztreonam S: 16/8, I: 32/16, R: >32/16 16/8 S >32/16 R Amikacin / Cefepime S: 16/8, I: 32/16, R: >32/16 >32/16 R >32/16 R Amikacin / Ceftazidime S: 16/8, I: 32/16, R: >32/16 16/8 S >32/16 R Amikacin / Ciprofloxacin S: 16/1, I: 32/2, R: >32/2 16/1 S 16/1 S Amikacin / Colistin S: 16/2, I: 32/4, R: >32/4 >32/4 R >32/4 R Amikacin / Meropenem S: 16/4, I: 32/8, R: >32/8 16/4 S 16/4 S Amikacin / Piperacilin / Tazo S: 16/32:4, I: 32/64:4, R: >32/64:4 16/32:4 S >32/64:4 R Amikacin / Trimethoprim / Sulfa S: 16/1:19, I: 32/2:38, R: >32/2:38 16/1:19 S >32/2:38 R Aztreonam S: 8, I: 16, R: >16 Cefepime S: 8, I: 16, R: >16 Ceftazidime S: 8, I: 16, R: >16 Chloramphenicol S: 8, I: 16, R: >16 Chloramphenicol / Ceftazidime S: 8/8, I: 16/16, R: >16/16 16/16 I >16/16 R Chloramphenicol / Meropenem S: 8/4, I: 16/8, R: >16/8 16/8 I >16/8 R Ciprofloxacin S: 1, I: 2, R: >2 1 S >2 R Ciprofloxacin / Aztreonam S: 1/8, I: 2/16, R: >2/16 1/8 S >2/16 R Ciprofloxacin / Colistin S: 1/2, I: 2/4, R: >2/4 1/2 S >2/4 R Ciprofloxacin / Meropenem S: 1/4, I: 2/8, R: >2/8 1/4 S >2/8 R Ciprofloxacin / Piperacilin / Tazo S: 1/32:4, I: 2/64:4, R: >2/64:4 1/32:4 S >2/64:4 R Ciprofloxacin / Trimethoprim / Sulfa S: 1/1:19, I: 2/2:38, R: >2/2:38 1/1:19 S >2/2:38 R Colistin S: 2, I: 4, R: >4 >4 R >4 R Gentamicin S: 4, I: 8, R: >8 >8 R >8 R Gentamicin / Aztreonam S: 4/8, I: 8/16, R: >8/16 >8/16 R >8/16 R Gentamicin / Cefepime S: 4/8, I: 8/16, R: >8/16 >8/16 R >8/16 R Gentamicin / Ceftazidime S: 4/8, I: 8/16, R: >8/16 >8/16 R >8/16 R Gentamicin / Ciprofloxacin S: 4/1, I: 8/2, R: >8/2 4/1 S >8/2 R Gentamicin / Colistin S: 4/2, I: 8/4, R: >8/4 >8/4 R >8/4 R Gentamicin / Meropenem S: 4/4, I: 8/8, R: >8/8 4/4 S 8/8 I Gentamicin / Piperacilin / Tazo S: 4/32:4, I: 8/64:4, R: >8/64:4 >8/64:4 R >8/64:4 R Gentamicin / Trimethoprim / Sulfa S: 4/1:19, I: 8/2:38, R: >8/2:38 4/1:19 S 8/2:38 I Meropenem S: 4, I: 8, R: >8 >8 R >8 R Piperacilin / Tazo S: 32:4, I: 64:4, R: >64:4 >64:4 R >64:4 R Tobramycin S: 4, I: 8, R: >8 >8 R >8 R Tobramycin / Aztreonam S: 4/8, I: 8/16, R: >8/16 4/8 S >8/16 R Tobramycin / Cefepime S: 4/8, I: 8/16, R: >8/16 >8/16 R >8/16 R Tobramycin / Ceftazidime S: 4/8, I: 8/16, R: >8/16 4/8 S >8/16 R Tobramycin / Ciprofloxacin S: 4/1, I: 8/2, R: >8/2 4/1 S 4/1 S Tobramycin / Colistin S: 4/2, I: 8/4, R: >8/4 >8/4 R >8/4 R Tobramycin / Meropenem S: 4/4, I: 8/8, R: >8/8 4/4 S 4/4 S Tobramycin / Piperacilin / Tazo S: 4/32:4, I: 8/64:4, R: >8/64:4 4/32:4 S >8/64:4 R Tobramycin / Trimethoprim / Sulfa S: 4/1:19, I: 8/2:38, R: >8/2:38 4/1:19 S >8/2:38 R Trimethoprim / Sulfa S: 1:19, I: 2:38, R: >2:38 >2:38 R >2:38 R Trimethoprim / Sulfa / Aztreonam S: 1:19/8, I: 2:38/16, R: >2:38/16 >2:38/16 R >2:38/16 R Trimethoprim / Sulfa / Ceftazidime S: 1:19/8, I: 2:38/16, R: >2:38/16 2:38/16 I >2:38/16 R Trimethoprim / Sulfa / Meropenem S: 1:19/4, I: 2:38/8, R: >2:38/8 2:38/8 I >2:38/8 R Trimethoprim / Sulfa / Piperacilin / Tazo S: 1:19/32:4, I: 2:38/64:4, R: >2:38/64:4 1:19/32:4 S >2:38/64:4 R S: Susceptible I: Intermediate R: Resistant Veterinary Biofilm Susceptibility Testing is a qualitative, in-vitro diagnostic test designed for use in determining antimicrobial susceptibility of both planktonic and biofilm phenotypes of veterinary isolates. Minimum Inhibitory Concentration (MIC) results are for planktonic cells susceptibility and Minimum Biofilm Eradication Concentration (MBEC) results are for biofilms susceptibility. Results for each individual antibiotic may be applied to other antibiotics in the same class. Brought to you by The Spectrum Group (800)553-1391 FIGURE 2: These results indicate that there were no single antibiotic options available and therefore a combination panel was required. The 4 antibiotic combination options that can provide possible* treatment for the above infection in a biofilm state: Amikacin/Ciprofloxacin, Amikacin/ Meropenum, Tobramycin/Ciprofloxacin and Tobramycin/Meropenum. The normal therapeutic dosage for a patient of this weight/size would be utilized, unless directed otherwise by your pharmacist or reference guide. *unless contraindicated toll-free (800) 553-1391 www.becscreen.com
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