{
  "url": "https://openlegislation.uk/eu-decision-2013-652/annex/part-A/division-4/division-4.2",
  "json_url": "https://openlegislation.uk/eu-decision-2013-652/annex/part-A/division-4/division-4.2.json",
  "legislation": "eudn/2013/652",
  "legislation_title": "Commission Implementing Decision of 12 November 2013 on the monitoring and reporting of antimicrobial resistance in zoonotic and commensal bacteria (notified under document C(2013) 7145) (Text with EEA relevance) (2013/652/EU)",
  "legislation_url": "https://openlegislation.uk/eu-decision-2013-652",
  "path": "annex/part/A/division/4/division/4.2",
  "kind": "division",
  "number": "4.2",
  "heading": "Method for further characterisation and classification of Salmonella spp. and E. coli isolates showing resistance to third-generation cephalosporins or meropenem",
  "text": "All presumptive ESBL- or AmpC- or carbapenemase-producing E. coli isolates identified through the selective plating described in point 4.1 as well as all those randomly selected isolates of Salmonella spp. and E. coli that after testing with the first panel of antimicrobials in accordance with Table 1, are resistant to cefotaxime or ceftazidime or meropenem, shall be further tested with a second panel of antimicrobial substances in accordance with Table 4. This panel includes cefoxitin, cefepime and clavulanate synergy test in combination with cefotaxime and ceftazidime for detection of ESBL and AmpC production. In addition the second panel also contains imipenem, meropenem and ertapenem to phenotypically verify the presumptive carbapenemase-producers.\nTable 4\nPanel of antimicrobial substances, EUCAST epidemiological cut-off values (ECOFFs) and clinical resistance breakpoints and concentrations ranges to be used for testing only Salmonella spp. and indicator commensal E. coli isolates resistant to cefotaxime or ceftazidime or meropenem — (Second panel)\nEUCAST epidemiological cut-off values.\nEUCAST clinical resistance breakpoints.\n4 mg/L clavulanic acid.\nThe values shall be compared to the values of Cefotaxime and Ceftazidime and interpreted according to CLSI or EUCAST guidelines regarding synergy testing.\nNAnot available.\nAntimicrobial\nSpecies\nInterpretative thresholds of AMR(mg/L)\nRange of concentrations (mg/L)(No of wells in brackets)\nECOFF\nClinical breakpoint\nCefoxitin\nSalmonella\n> 8\nNA\n0,5-64 (8)\nE. coli\n> 8\nNA\nCefepime\nSalmonella\nNA\nNA\n0,06-32 (10)\nE. coli\n> 0,125\n> 4\nCefotaxime + clavulanic acid\nSalmonella\nNA\nNA\n0,06-64 (11)\nE. coli\nNA\nNA\nCeftazidime + clavulanic acid\nSalmonella\nNA\nNA\n0,125-128 (11)\nE. coli\nNA\nNA\nMeropenem\nSalmonella\n> 0,125\n> 8\n0,03-16 (10)\nE. coli\n> 0,125\n> 8\nTemocillin\nSalmonella\nNA\nNA\n0,5-64 (8)\nE. coli\nNA\nNA\nImipenem\nSalmonella\n> 1\n> 8\n0,12-16 (8)\nE. coli\n> 0,5\n> 8\nErtapenem\nSalmonella\n> 0,06\n> 1\n0,015-2 (8)\nE. coli\n> 0,06\n> 1\nCefotaxime\nSalmonella\n> 0.5\n> 2\n0,25-64 (9)\nE. coli\n> 0,25\n> 2\nCeftazidime\nSalmonella\n> 2\n> 4\n0,25-128 (10)\nE. coli\n> 0,5\n> 4",
  "extent": "E+W+S+N.I.",
  "status": null,
  "version": "current",
  "annotations": [
    {
      "type": "footnote",
      "label": "f1",
      "text": "EUCAST epidemiological cut-off values."
    },
    {
      "type": "footnote",
      "label": "f2",
      "text": "EUCAST clinical resistance breakpoints."
    },
    {
      "type": "footnote",
      "label": "f3",
      "text": "4 mg/L clavulanic acid."
    },
    {
      "type": "footnote",
      "label": "f4",
      "text": "The values shall be compared to the values of Cefotaxime and Ceftazidime and interpreted according to CLSI or EUCAST guidelines regarding synergy testing."
    }
  ],
  "outstanding_effects": [],
  "provenance": {
    "source": "legislation.gov.uk",
    "source_url": "https://www.legislation.gov.uk/eudn/2013/652/annex/part/A/division/4/division/4.2",
    "retrieved_at": "2026-11-01T15:14:58.611363+00:00"
  },
  "licence": "Open Government Licence v3.0",
  "licence_url": "https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/",
  "attribution": "Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives."
}