Division 3 Antimicrobials for susceptibility testing, epidemiological cut-off values and concentration ranges to be used for antimicrobial susceptibility testing of the isolates
United Kingdom
F1The appropriate Minister must test the antimicrobials and interpret the results using the epidemiological cut-off values and the concentration ranges that are set out in Tables 1, 2 and 3, to determine the susceptibility of Salmonella spp., C. coli, C. jejuni, indicator commensal E. coli, E. faecalis and E. faecium.
Dilution methods shall be performed according to the methods described by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Clinical and Laboratory Standards Institute (CLSI), accepted as the international reference method (ISO standard 20776-1:2006).
Table 1
Panel of antimicrobial substances to be included in AMR monitoring, EUCAST thresholds for resistance and concentration ranges to be tested in Salmonella spp. and indicator commensal E. coli (First panel)
EUCAST epidemiological cut-off values. | ||||
EUCAST clinical resistance breakpoints. | ||||
Data from EUCAST available for Salmonella Enteriditis, Typhimurium, Typhi and Paratyphi. | ||||
| NA not available. | ||||
| Antimicrobial | Species | Interpretative thresholds of AMR(mg/L) | Range of concentrations (mg/L)(No of wells in brackets) | |
|---|---|---|---|---|
| ECOFFf1 | Clinical breakpointf2 | |||
| Ampicillin | Salmonella | > 8 | > 8 | 1-64 (7) |
| E. coli | > 8 | > 8 | ||
| Cefotaxime | Salmonella | > 0,5 | > 2 | 0,25-4 (5) |
| E. coli | > 0,25 | > 2 | ||
| Ceftazidime | Salmonella | > 2 | > 4 | 0,5-8 (5) |
| E. coli | > 0,5 | > 4 | ||
| Meropenem | Salmonella | > 0,125 | > 8 | 0,03-16 (10) |
| E. coli | > 0,125 | > 8 | ||
| Nalidixic acid | Salmonella | > 16 | NA | 4-128 (6) |
| E. coli | > 16 | NA | ||
| Ciprofloxacin | Salmonella | > 0,064 | > 1 | 0,015-8 (10) |
| E. coli | > 0,064 | > 1 | ||
| Tetracycline | Salmonella | > 8 | NA | 2-64 (6) |
| E. coli | > 8 | NA | ||
| Colistin | Salmonella | > 2 | > 2 | 1-16 (5) |
| E. coli | > 2 | > 2 | ||
| Gentamicin | Salmonella | > 2 | > 4 | 0,5-32 (7) |
| E. coli | > 2 | > 4 | ||
| Trimethoprim | Salmonella | > 2 | > 4 | 0,25-32 (8) |
| E. coli | > 2 | > 4 | ||
| Sulfamethoxazole | Salmonella | NA | NA | 8-1 024 (8) |
| E. coli | > 64 | NA | ||
| Chloramphenicol | Salmonella | > 16 | > 8 | 8-128 (5) |
| E. coli | > 16 | > 8 | ||
| Azithromycin | Salmonella | NA | NA | 2-64 (6) |
| E. coli | NA | NA | ||
| Tigecycline | Salmonella | > 1f3 | > 2 | 0,25-8 (6) |
| E. coli | > 1 | > 2 | ||
Table 2
Panel of antimicrobial substances to be included in AMR monitoring, EUCAST interpretative thresholds for resistance and concentration ranges to be tested in C. jejuni and C. coli
EUCAST epidemiological cut-off values. | ||||
EUCAST clinical resistance breakpoints. | ||||
At a voluntary basis. | ||||
| NA not available. | ||||
| Antimicrobial | Species | Interpretative thresholds of AMR(mg/L) | Range of concentrations (mg/L)(No of wells in brackets) | |
|---|---|---|---|---|
| ECOFFf4 | Clinical breakpointf5 | |||
| Erythromycin | C. jejuni | > 4 | > 4 | 1-128 (8) |
| C. coli | > 8 | > 8 | ||
| Ciprofloxacin | C. jejuni | > 0,5 | > 0,5 | 0,12-16 (8) |
| C. coli | > 0,5 | > 0,5 | ||
| Tetracycline | C. jejuni | > 1 | > 2 | 0,5-64 (8) |
| C. coli | > 2 | > 2 | ||
| Gentamicin | C. jejuni | > 2 | NA | 0,12-16 (8) |
| C. coli | > 2 | NA | ||
| Nalidixic acid | C. jejuni | > 16 | NA | 1-64 (7) |
| C. coli | > 16 | NA | ||
| Streptomycinf6 | C. jejuni | > 4 | NA | 0,25-16 (7) |
| C. coli | > 4 | NA | ||
Table 3
Panel of antimicrobial substances to be included in AMR monitoring, EUCAST thresholds for resistance and concentration ranges to be tested in E. faecalis and E. faecium
EUCAST epidemiological cut-off values. | ||||
EUCAST clinical resistance breakpoints. | ||||
| NA not available. | ||||
| Antimicrobial | Species | Interpretative thresholds of AMR(mg/L) | Range of concentrations (mg/L)(No of wells in brackets) | |
|---|---|---|---|---|
| ECOFFf7 | Clinical breakpointf8 | |||
| Gentamicin | E. faecalis | > 32 | NA | 8-1 024 (8) |
| E. faecium | > 32 | NA | ||
| Chloramphenicol | E. faecalis | > 32 | NA | 4-128 (6) |
| E. faecium | > 32 | NA | ||
| Ampicillin | E. faecalis | > 4 | > 8 | 0,5-64 (8) |
| E. faecium | > 4 | > 8 | ||
| Vancomycin | E. faecalis | > 4 | > 4 | 1-128 (8) |
| E. faecium | > 4 | > 4 | ||
| Teicoplanin | E. faecalis | > 2 | > 2 | 0,5-64 (8) |
| E. faecium | > 2 | > 2 | ||
| Erythromycin | E. faecalis | > 4 | NA | 1-128 (8) |
| E. faecium | > 4 | NA | ||
| Quinupristin/Dalfopristin | E. faecalis | NA | NA | 0,5-64 (8) |
| E. faecium | > 1 | > 4 | ||
| Tetracycline | E. faecalis | > 4 | NA | 1-128 (8) |
| E. faecium | > 4 | NA | ||
| Tigecycline | E. faecalis | > 0,25 | > 0,5 | 0,03-4 (8) |
| E. faecium | > 0,25 | > 0,5 | ||
| Linezolid | E. faecalis | > 4 | > 4 | 0,5-64 (8) |
| E. faecium | > 4 | > 4 | ||
| Daptomycin | E. faecalis | > 4 | NA | 0,25-32 (8) |
| E. faecium | > 4 | NA | ||
| Ciprofloxacin | E. faecalis | > 4 | NA | 0,12-16 (8) |
| E. faecium | > 4 | NA | ||
Annotations
Textual amendments
- F1
Words in Annex Pt. A point 3 substituted (31.12.2020) by The Zoonotic Disease Eradication and Control (Amendment) (EU Exit) Regulations 2019 (S.I. 2019/740), regs. 1, 11(15); 2020 c. 1, Sch. 5 para. 1(1)
Footnotes
- f1
EUCAST epidemiological cut-off values.
- f2
EUCAST clinical resistance breakpoints.
- f3
Data from EUCAST available for Salmonella Enteriditis, Typhimurium, Typhi and Paratyphi.
- f4
EUCAST epidemiological cut-off values.
- f5
EUCAST clinical resistance breakpoints.
- f6
At a voluntary basis.
- f7
EUCAST epidemiological cut-off values.
- f8
EUCAST clinical resistance breakpoints.