scholarly journals The Clinical and Laboratory Standards Institute Subcommittee on Antimicrobial Susceptibility Testing: Background, Organization, Functions, and Processes

2020 ◽  
Vol 58 (3) ◽  
Author(s):  
Melvin P. Weinstein ◽  
James S. Lewis
Keyword(s):  
Infectious Disease ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Performance Standards ◽  
The United States ◽  
Antimicrobial Susceptibility Testing ◽  
Face To Face ◽  
Standards And Guidelines ◽  
Financial Dependency ◽  
Operational Processes

ABSTRACT The Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antimicrobial Susceptibility Testing (AST SC) is a volunteer-led, multidisciplinary consensus body that develops and publishes standards and guidelines (among other products) for antimicrobial susceptibility testing (AST) methods and results interpretation in the United States and internationally. The Subcommittee (SC) meets face-to-face twice yearly, and its working groups (WGs) are active throughout the year via teleconferences. All meetings are open to the public. Participants include clinical microbiologists, infectious disease (ID) pharmacists, and infectious disease physicians representing the health care professions, government, and industry. Individuals who work for a company with a primary financial dependency on drug sales cannot serve as voting members, and well-defined conflict of interest polices are in place. In addition to developing and updating susceptibility breakpoints, the SC develops and validates new testing methods, provides guidance on how results should be interpreted and applied, sets quality control ranges, and educates users through seminars, symposia, and webinars. Based on its work, the SC publishes print and electronic standards and guidelines, including an annual update, the Performance Standards for Antimicrobial Susceptibility Testing (M100). This commentary will describe the background, organization, functions, and operational processes of the AST SC.

Overview of Changes to the Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing, M100, 31 st Edition

2021 ◽  
Author(s):  
Romney Humphries ◽  
April M. Bobenchik ◽  
Janet A. Hindler ◽  
Audrey N. Schuetz
Keyword(s):  
Staphylococcus Aureus ◽  
Cerebrospinal Fluid ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Performance Standards ◽  
Test Methods ◽  
Culture Broth ◽  
Antimicrobial Susceptibility Testing ◽  
Disk Diffusion ◽  
Standards And Guidelines

The Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antimicrobial Susceptibility Testing (AST) develops and publishes standards and guidelines for AST methods and results interpretation, in an annual update to the Performance Standards for Antimicrobial Susceptibility Testing (M100). This mini-review will discuss changes to M100 for the 31 st Edition, including new and revised breakpoints and testing recommendations. New MIC and disk diffusion breakpoints are described for azithromycin ( Shigella spp.), imipenem-relebactam ( Enterobacterales , Pseudomonas aeruginosa and anaerobes), lefamulin ( Staphylococcus aureus , Haemophilus influenzae and Streptococcus pneumoniae ) and disk breakpoints for azithromycin and Neisseria gonorrhoeae . The rationale behind revised oxacillin MIC breakpoints for select staphylococci is discussed. Updates to test methods include a method for disk diffusion using positive blood culture broth and use of linezolid to predict tedizolid susceptibility. Clarification on which drugs to suppress on bacteria isolated from the cerebrospinal fluid, and clarification on the use of a caret symbol attached to the intermediate category (“I^”) to indicate those antimicrobials that concentrate in the urine.

scholarly journals Implementation of rapid antimicrobial susceptibility testing combined with routine infectious disease bedside consultation in clinical practice (RAST-ID): a prospective single-centre study

2020 ◽  
Vol 76 (1) ◽  
pp. 233-238
Author(s):  
Thomas Valentin ◽  
Elisabeth Koenig ◽  
Juergen Prattes ◽  
Stefanie Wunsch ◽  
Tobias Loizenbaur ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Real Life ◽  
Antimicrobial Treatment ◽  
Antimicrobial Susceptibility Testing ◽  
Resistance Testing ◽  
Single Centre ◽  
Life Impact ◽  
Clinical Consequences

Abstract Objectives Recently, EUCAST released guidelines for rapid antimicrobial susceptibility testing (RAST) directly from positive blood culture bottles. The aim of our prospective single-centre clinical study was to assess the proportion of readable results and errors compared with routine antimicrobial susceptibility testing and the clinical consequences drawn by infectious disease (ID) physicians from RAST results during same-day bedside consultation. Methods All positive blood cultures suitable for RAST from January to December 2019 were included and RAST results at 4 and 6 h compared with standard disc diffusion. The real-life impact of RAST on clinical decisions was assessed during same-day ID bedside consultation. Results The proportion of readable RAST results was significantly higher after 6 h of incubation compared with after 4 h (881/930 versus 642/847; P < 0.0001). Major and very major errors were rare (17/642 after 4 h and 12/881 after 6 h; P = 0.087). ID consultation was performed in 134 patients after the RAST result. Antimicrobial treatment was changed in 73 patients and 84 additional measures (i.e. imaging studies, surgery, additional resistance testing) were ordered in 62 patients. Conclusions RAST according to EUCAST methods was easy to implement with a low number of major and very major errors after 6 h of incubation. ID physicians performing bedside consultations frequently used this information to change antimicrobial treatment and recommended additional measures.

scholarly journals Antimicrobial susceptibility testing of Neisseria gonorrhoeae and implications for epidemiology and therapy.

1993 ◽  
Vol 6 (1) ◽  
pp. 22-33 ◽  
Author(s):  
T Fekete
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Susceptibility Testing ◽  
The United States ◽  
Primary Treatment ◽  
Antimicrobial Susceptibility Testing ◽  
Response To Therapy ◽  
In Vitro Tests

Antimicrobial susceptibility testing (AST) of Neisseria gonorrhoeae has been under development since the early days of antimicrobial agents. However, it is rarely applied to clinical isolates today. The history of the various in vitro tests to determine the susceptibility of N. gonorrhoeae to antibiotics is rich with evidence that these results predict response to therapy for almost all agents tested. Further, AST is a useful and important aspect of strain characterization and disease epidemiology in conjunction with the more specific but laborious techniques of auxotyping, serotyping, and plasmid analysis. Current technology has overcome many of the objections to AST for N. gonorrhoeae with standardization of test media and the development of an accurate disk diffusion AST method that is suited to most clinical laboratories regardless of volume or level of technical expertise. Ironically, the very low level of resistance to the current primary treatment strategy in the United States, ceftriaxone or another potent cephalosporin, makes the use of AST somewhat superfluous.

scholarly journals A survey of methods used for antimicrobial susceptibility testing in veterinary diagnostic laboratories in the United States

2017 ◽  
Vol 29 (5) ◽  
pp. 669-675 ◽  
Author(s):  
David A. Dargatz ◽  
Matthew M. Erdman ◽  
Beth Harris
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Clinical Laboratory ◽  
The United States ◽  
Antimicrobial Susceptibility Testing ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Broth Microdilution

Antimicrobial resistance is a serious threat to animal and human health worldwide, requiring a collaborative, holistic approach. The U.S. Government has developed a national strategy to address antimicrobial resistance, with one component being to monitor antimicrobial resistance in agricultural settings. We developed a survey to collect information about antimicrobial susceptibility testing (AST) from the veterinary diagnostic laboratory community in the United States, assessing current practices and technologies and determining how AST information is shared. Of the 132 surveys administered, 52 (39%) were returned. Overall, responding laboratories conducted susceptibility tests on 98,788 bacterial isolates in 2014, with Escherichia coli being the most common pathogen tested across all animal species. The 2 most common AST methods employed were the disk diffusion method (71%) and the Sensititre platform broth microdilution system (59%). Laboratories primarily used the Clinical Laboratory Standards Institute (CLSI) VET-01 standard (69%) and the automatically calculated interpretations provided by the commercial AST systems (61%) for interpreting their AST data. Only 22% of laboratories published AST data on a periodic basis, usually via annual reports published on the laboratory’s website or through peer-reviewed journals for specific pathogens. Our results confirm that disk diffusion and broth microdilution remain the standard AST methods employed by U.S. veterinary diagnostic laboratories, and that CLSI standards are commonly used for interpreting AST results. This information will help determine the most efficient standardized methodology for future surveillance. Furthermore, the current infrastructure within laboratories, once harmonized, will help provide a mechanism for conducting national surveillance programs.

scholarly journals IMP-27, a Unique Metallo-β-Lactamase Identified in Geographically Distinct Isolates of Proteus mirabilis

2016 ◽  
Vol 60 (10) ◽  
pp. 6418-6421 ◽  
Author(s):  
Nyssa Dixon ◽  
Randal C. Fowler ◽  
A. Yoshizumi ◽  
Tsukasa Horiyama ◽  
Y. Ishii ◽  
...  
Keyword(s):  
United States ◽  
Antimicrobial Susceptibility ◽  
Proteus Mirabilis ◽  
Susceptibility Testing ◽  
Gene Cassette ◽  
The United States ◽  
Antimicrobial Susceptibility Testing ◽  
Content Type ◽  
Lactamase Gene

ABSTRACTA novel metallo-β-lactamase gene,blaIMP-27, was identified in unrelatedProteus mirabilisisolates from two geographically distinct locations in the United States. Both isolates harborblaIMP-27as part of the first gene cassette in a class 2 integron. Antimicrobial susceptibility testing indicated susceptibility to aztreonam, piperacillin-tazobactam, and ceftazidime but resistance to ertapenem. However, hydrolysis assays indicated that ceftazidime was a substrate for IMP-27.

scholarly journals Polymyxin Susceptibility Testing and Interpretive Breakpoints: Recommendations from the United States Committee on Antimicrobial Susceptibility Testing (USCAST)

2019 ◽  
Vol 64 (2) ◽  
Author(s):  
Jason M. Pogue ◽  
Ronald N. Jones ◽  
John S. Bradley ◽  
David R. Andes ◽  
Sujata M. Bhavnani ◽  
...  
Keyword(s):  
United States ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Polymyxin B ◽  
The United States ◽  
Antimicrobial Susceptibility Testing ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Testing Strategies ◽  
Tract Infections

ABSTRACT The polymyxins are important agents for carbapenem-resistant Gram-negative bacilli. The United States Committee on Antimicrobial Susceptibility Testing breakpoint recommendations for colistin and polymyxin B are that isolates of Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae are considered susceptible at MIC values of ≤2 mg/liter. These recommendations are contingent upon dosing and testing strategies that are described in this commentary. Importantly, these recommendations are not applicable to lower respiratory tract infections, for which we recommend no breakpoints. Furthermore, there is no breakpoint recommendation for polymyxin B for lower urinary tract infections.

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