Establishing MIC breakpoints and the interpretation of in vitro susceptibility tests Department of Medical Microbiology North Bristol NHS Trust Southmead Hospital WestburyonTrym Bristol BS NB Departm
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Establishing MIC breakpoints and the interpretation of in vitro susceptibility tests Department of Medical Microbiology North Bristol NHS Trust Southmead Hospital WestburyonTrym Bristol BS NB Departm

brPage 4br Microbiological considerations brPage 5br Escherichia coli Staphylococcus aureus Pharmacological and pharmacokinetic features brPage 6br in vitro Clinical issues The process of setting a breakpoint brPage 7br Clinical Microbiology and Inf

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Establishing MIC breakpoints and the interpretation of in vitro susceptibility tests Department of Medical Microbiology North Bristol NHS Trust Southmead Hospital WestburyonTrym Bristol BS NB Departm




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Presentation on theme: "Establishing MIC breakpoints and the interpretation of in vitro susceptibility tests Department of Medical Microbiology North Bristol NHS Trust Southmead Hospital WestburyonTrym Bristol BS NB Departm"— Presentation transcript:


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Establishing MIC breakpoints and the interpretation of in vitro susceptibility tests Department of Medical Microbiology, North Bristol NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB; Department of Microbiology, City Hospital NHS Trust, Birmingham B18 7QH, UK
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Introduction in vitro
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Current procedures for establishing individual breakpoints.
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Microbiological considerations
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Escherichia coli Staphylococcus aureus Pharmacological and pharmacokinetic features
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in vitro Clinical

issues The process of 'setting' a breakpoint
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Clinical Microbiology and Infection Pseudomonas aeruginosa
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Group representative susceptibility testing Future developments of the Working Party Proposed interpretative breakpoints fo r individual antimicrobial agents Moraxella catarrhalis Haemophilus influenzae Pseudomonas
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References Journal of Antimicrobial Chemotherapy 48, Suppl. 1, Development of In Vitro Susceptibility Testing Criteria and Quality Control Parameters: Approved Standard M23-T3. Vol. 18, No. 5. Clinical Microbiology and Infection

2, Suppl. 1, Scandinavian Journal of Infectious Diseases, Suppl.105, Journal of Antimicrobial Chemotherapy 27, Suppl. D, Antimicrobial Agents and Chemotherapy 37 Journal of Antimicrobial Chemotherapy 48 Suppl. Journal of Infectious Diseases 130 Journal of Antimicrobial Chemotherapy 38
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Table I. M. catarrhalis H. influenzae
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H. influenzae M. catarrhalis S. pneumoniae H. influenzae
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Table II. Pseudomonas
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Pseudomonas
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Table III. M. catarrhalis, H. influenzae

Pseudomonas
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M. catarrhalis, H. influenzae Pseudomonas
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M. catarrhalis, H. influenzae Pseudomonas S. pneumoniae Pseudomonas H. influenzae
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Table IV
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Table V Aminoglycosides EUCAST/BSAC clinical MIC breakpoints Aminoglycosides Species-related breakpoints (S) Non-species related breakpoints S Enterobac- teriaceae Pseudo- monas Acineto- bacter Staphylo- coccus Entero- coccus Strepto- coccus A,B,C,G S.pneu- moniae H.influenzae M.catarrhalis N.gonorr- hoeae N.mening- itidis Gram- negative anaerobes Amikacin -- -- -- -- -- -- 8/16

Gentamicin -- -- -- -- -- -- 2/4 Netilmicin -- -- -- -- -- -- 2/4 Tobramycin -- -- -- -- -- -- 2/4 1. 2. Pseudomonas Acinetobacter 3. Enterococcus 4. 5. -- IE -- IE
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Table VI Glycopeptides EUCAST /BSAC clinical MIC breakpoints Glycopeptides Species-related breakpoints (S) Non- species related breakpoints S Enterobac- teriaceae Pseudo- monas Acineto- bacter Staphylo- coccus Entero- coccus Strepto- coccus A,B,C,G S.pneu- moniae H.influenzae M.catarrhalis N.gonorr- hoeae N.mening- itidis Gram- negative anaerobes Vancomycin -- -- -- -- -- -- -- Teicoplanin -- -- -- -- -- -- --

1. Staphylococcus aureus 2. -- IE -- IE
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Table VII Oxazolidinones EUCAST /BSAC clinical MIC breakpoints Oxazolidinone Species-related breakpoints (S) Non-species related breakpoints Enterobac- teriaceae Pseudo- monas Acineto- bacter Staphylo- coccus Entero- coccus Strepto- coccus A,B,C,G S.pneu- moniae H.influenzae M.catarrhalis N.gonorr- hoeae N.mening- itidis Gram- negative anaerobes Linezolid -- -- -- -- -- -- -- 1. 2. -- IE -- IE
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Table VIII Fluoroquinolones EUCAST/BSAC clinical MIC breakpoints Fluoroquinolone Species-related breakpoints (S) Non-

species related breakpoints S Entero- bacteriaceae Pseudo- monas/ Acineto- bacter Staphylo- coccus Entero- coccus Strepto- coccus A,B,C,G S.pneu- moniae H.influenzae M.catarrhalis N.gonorr- hoeae N.menin- gitidis Gram- negative anaerobes Ciprofloxacin -- -- -- Levofloxacin -- Moxifloxacin -- -- -- Norfloxacin -- -- -- -- -- -- -- -- -- Ofloxacin -- -- -- -- 1. pefloxacin enoxacin 2. Salmonella Salmonella S.typhi Salmonella 3. Staphylococcus 4. Streptococcus pneumoniae S.pneumoniae 5. Haemophilus/Moraxella H.influenzae H.influenzae. 6. Neisseria meningitidis 7. -- IE -- IE = Susceptibility

testing not recommended as the species is a poor target for therapy with the drug. = There is insufficient evidence that the species in question is a good target for therapy with the drug.