OpenLegislation

Commission Implementing Decision (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions (Text with EEA relevance)

EU Decision 2018/945 · Adopted 22 June 2018 · Extends to United Kingdom

Original text. legislation.gov.uk does not revise this item, so later amendments are not shown here. Changes made to it are listed under each provision when known.

Commission Implementing Decision (EU) 2018/945

of 22 June 2018

on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions

(Text with EEA relevance)

THE EUROPEAN COMMISSION,

Having regard to the Treaty on the Functioning of the European Union,

Having regard to Decision No 1082/2013/EU of the European Parliament and of the Council of 22 October 2013 on serious cross-border threats to health and repealing Decision No 2119/98/ECf1, and in particular Article 6(5)(a) and (b) thereof,

Whereas:

(1)

Pursuant to Decision No 2119/98/EC of the European Parliament and of the Councilf2, Commission Decision 2000/96/ECf3 established a list of communicable diseases and special health issues to be covered by epidemiological surveillance in the Community network.

(2)

Commission Decision 2002/253/ECf4 laid down case definitions for reporting communicable diseases listed in Decision 2000/96/EC to the Community network.

(3)

The Annex to Decision No 1082/2013/EU sets out the criteria for selecting the communicable diseases and related special health issues to be covered by epidemiological surveillance within the network.

(4)

The list of diseases and related special health issues established by Decision 2000/96/EC should be updated to reflect changes in disease incidence and prevalence, the needs of the European Union and its Member States, as well as to ensure compliance with the criteria provided in the Annex to Decision No 1082/2013/EU.

(5)

The list of case definitions should be updated in the light of new scientific information and evolving laboratory diagnostic criteria and practices.

(6)

Both the list of diseases and the list of case definitions are brought into line with the World Health Organisation nomenclature according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10).

(7)

The updated list of diseases should cover the following communicable diseases threatening public health that have emerged or re-emerged more recently in accordance with the criteria provided in the Annex to Decision No 1082/2013/EU for selection of communicable diseases and related special health issues to be covered by epidemiological surveillance:

  • Chikungunya: In view of autochthonous outbreaks of chikungunya virus infections in Italy (2007) and France (2010 and 2014), the widespread presence of competent vectors (Aedes albopictus) in the Mediterranean basin, and the return of travellers from endemic areas, systematic surveillance is necessary to prevent the spread of chikungunya virus in the Union,

  • Dengue: The large dengue outbreak in Madeira in 2012 and the presence of competent vectors (Aedes mosquitos), in particular in Mediterranean Member States, highlight the need for additional surveillance to help prevent the spread of the dengue virus in the Union,

  • Zika: The infection of pregnant women with the Zika virus can lead to the birth of children with severe neurological defects. Early detection and surveillance of people returning from affected areas are crucial. Surveillance data is needed to inform public health measures to prevent the introduction and spread of the Zika virus to the Union,

  • Lyme neuroborreliosis: The transmission of Lyme neuroborreliosis, a complication of Lyme disease which is caused by the bacterium Borrelia burgdorferi and transmitted to humans through the bite of infected ticks, is a concern for the Union. Systematic surveillance is needed to monitor its epidemiology in order to support measures to prevent and control the disease and its complications.

(8)

Pursuant to Article 9 of Regulation (EC) No 851/2004 of the European Parliament and of the Councilf5, the European Centre for Disease Prevention and Control (‘ECDC’) has, at the Commission's request, provided scientific assistance on the establishment of case definitions for Chikungunya, Dengue, Lyme neuroborreliosis and Zika infections on the revision of case definitions for a number of other diseasesf6, as well as on the revision of case definitions related to certain healthcare associated infections and to antimicrobial resistancef7. The case definitions should therefore be amended accordingly.

(9)

The measures provided for in this Decision are in accordance with the opinion of the Committee on serious cross-border threats to health established under Article 18 of Decision No 1082/2013/EU.

(10)

Accordingly, Decisions 2000/96/EC and 2002/253/EC should be replaced by this Decision,

HAS ADOPTED THIS DECISION:

Annotations to the whole text

Footnotes

f1

OJ L 293, 5.11.2013, p. 1.

f2

Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community (OJ L 268, 3.10.1998, p. 1).

f3

Commission Decision 2000/96/EC of 22 December 1999 on the communicable diseases to be progressively covered by the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (OJ L 28, 3.2.2000, p. 50).

f4

Commission Decision 2002/253/EC of 19 March 2002 laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (OJ L 86, 3.4.2002, p. 44).

f5

Regulation (EC) No 851/2004 of the European Parliament and of the Council of 21 April 2004 establishing a European Centre for disease prevention and control (OJ L 142, 30.4.2004, p. 1).

f6

Botulism, brucellosis, campylobacter enteritis, giardiasis, gonococcal infection, listeriosis, rubella, salmonella enteritis, shiga toxin/verocytotoxin-producing E. coli infection, shigellosis, syphilis and congenital syphilis, tetanus, tuberculosis, typhoid and paratyphoid fevers, pertussis, enteritis due to Yersinia enterocolitica or Yersinia pseudotuberculosis and healthcare-associated infections.

f7

In general and, more specifically, campylobacter enteritis, gonococcal infection, salmonella enteritis, shigellosis, tuberculosis and bloodstream infections due to specific pathogens, in particular Staphylococcus aureus (susceptibility to meticillin and other anti-staphylococcal beta-lactams), Enterococcus faecium and Enterococcus faecalis (susceptibility to glycopeptides), Klebsiella pneumoniae and Escherichia coli (susceptibility to carbapenems and to colistin in carbapenem-resistant isolates), and Pseudomonas aeruginosa and Acinetobacter species (susceptibility to carbapenems).

Contents

  1. 1Article 1
  2. 2Article 2
  3. 3Article 3
  4. 4Article 4
  5. Signature
  6. Annex I: Communicable diseases and related special health issues to be covered by the epidemiological surveillance network
  7. 1DISEASES
  8. 2SPECIAL HEALTH ISSUES
  9. Annex II
  10. EXPLANATION OF THE SECTIONS USED IN THE DEFINITION AND CLASSIFICATION OF CASES
  11. CLINICAL CRITERIA
  12. LABORATORY CRITERIA
  13. EPIDEMIOLOGICAL CRITERIA AND EPIDEMIOLOGICAL LINK
  14. CASE CLASSIFICATION
  15. POSSIBLE CASE
  16. PROBABLE CASE
  17. CONFIRMED CASE
  18. LABORATORY-CONFIRMED CASE WITH CLINICAL CRITERIA
  19. LABORATORY-CONFIRMED CASE WITH UNKNOWN CLINICAL CRITERIA
  20. LABORATORY-CONFIRMED CASE WITHOUT CLINICAL CRITERIA
  21. 2ABBREVIATION LIST
  22. CASE DEFINITIONS OF COMMUNICABLE DISEASES
  23. ANTHRAX
  24. Clinical Criteria
  25. Laboratory Criteria
  26. Epidemiological Criteria
  27. Case Classification
  28. Division
  29. BOTULISM
  30. Clinical Criteria
  31. Laboratory Criteria
  32. Epidemiological Criteria
  33. Case Classification
  34. BRUCELLOSIS
  35. Clinical Criteria
  36. Laboratory Criteria
  37. Epidemiological Criteria
  38. Case Classification
  39. Division
  40. CAMPYLOBACTER ENTERITIS
  41. Clinical Criteria
  42. Laboratory Criteria
  43. Division
  44. Epidemiological Criteria
  45. Case Classification
  46. Division
  47. Antimicrobial resistance
  48. CHIKUNGUNYA VIRUS DISEASE
  49. Clinical Criteria
  50. Laboratory Criteria
  51. AProbable case
  52. BConfirmed case
  53. Epidemiological Criteria
  54. Case Classification
  55. Division
  56. CHLAMYDIAL INFECTION, INCLUDING CHLAMYDIAL LYMPHOGRANULOMA (VENEREUM) (LGV)
  57. Clinical Criteria
  58. Laboratory Criteria
  59. Chlamydial infection non-LGV
  60. LGV
  61. Epidemiological Criteria
  62. Case Classification
  63. CHOLERA
  64. Clinical Criteria
  65. Laboratory Criteria
  66. Epidemiological Criteria
  67. Case Classification
  68. Division
  69. CREUTZFELDT-JAKOB DISEASE (CJD)
  70. Preconditions
  71. Clinical Criteria
  72. Diagnostic Criteria
  73. Diagnostic criteria for case confirmation:
  74. Diagnostic criteria for a probable or a possible case:
  75. Epidemiological Criteria
  76. Case Classification
  77. CRYPTOSPORIDIOSIS
  78. Clinical Criteria
  79. Laboratory Criteria
  80. Epidemiological Criteria
  81. Case Classification
  82. Division
  83. DENGUE
  84. Clinical Criteria
  85. Laboratory Criteria
  86. AProbable case
  87. BConfirmed case
  88. Epidemiological Criteria
  89. Case Classification
  90. DIPHTHERIA
  91. Clinical Criteria
  92. Laboratory Criteria
  93. Epidemiological Criteria
  94. Case Classification
  95. 3.12ECHINOCOCCOSIS
  96. Clinical Criteria
  97. Diagnostic Criteria
  98. Case Classification
  99. GIARDIASIS (LAMBLIASIS)
  100. Clinical Criteria
  101. Laboratory Criteria
  102. Epidemiological Criteria
  103. Case Classification
  104. Division
  105. GONOCOCCAL INFECTION
  106. Clinical Criteria
  107. Laboratory Criteria
  108. Epidemiological Criteria
  109. Case Classification
  110. Antimicrobial resistance
  111. 3.15HAEMOPHILUS INFLUENZAE INFECTION, INVASIVE DISEASE
  112. Clinical Criteria
  113. Laboratory Criteria
  114. Case Classification
  115. ACUTE HEPATITIS A
  116. Clinical Criteria
  117. Laboratory Criteria
  118. Epidemiological Criteria
  119. Case Classification
  120. Division
  121. HEPATITIS B
  122. Clinical Criteria
  123. Laboratory Criteria
  124. Epidemiological Criteria
  125. Case Classification
  126. 3.18HEPATITIS C
  127. Clinical Criteria
  128. Laboratory Criteria
  129. Case Classification
  130. 3.19HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION AND ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)
  131. Clinical Criteria (AIDS)
  132. Laboratory Criteria (HIV)
  133. Case Classification
  134. INFLUENZA
  135. Clinical Criteria
  136. Laboratory Criteria
  137. Epidemiological Criteria
  138. Case Classification
  139. INFLUENZA A/H5N1
  140. Clinical Criteria
  141. Laboratory Criteria
  142. Epidemiological Criteria
  143. Case Classification
  144. 3.22LEGIONNAIRES' DISEASE
  145. Clinical Criteria
  146. Laboratory Criteria
  147. Laboratory criteria for case confirmation
  148. Laboratory criteria for a probable case
  149. Case Classification
  150. LEPTOSPIROSIS
  151. Clinical Criteria
  152. Laboratory Criteria
  153. Epidemiological Criteria
  154. Case Classification
  155. Division
  156. LISTERIOSIS
  157. Clinical Criteria
  158. Listeriosis in pregnancy:
  159. Laboratory Criteria
  160. Epidemiological Criteria
  161. Case Classification
  162. Division
  163. LYME NEUROBORRELIOSIS
  164. Clinical Criteria
  165. Laboratory Criteria
  166. AConfirmed case
  167. BProbable case
  168. Epidemiological Criteria
  169. Case Classification
  170. 3.26MALARIA
  171. Clinical Criteria
  172. Laboratory Criteria
  173. Case Classification
  174. Division
  175. MEASLES
  176. Clinical Criteria
  177. Laboratory Criteria
  178. Epidemiological criteria
  179. Case Classification
  180. MENINGOCOCCAL INFECTION, INVASIVE DISEASE
  181. Clinical Criteria
  182. Laboratory Criteria
  183. Epidemiological Criteria
  184. Case Classification
  185. MUMPS
  186. Clinical Criteria
  187. Laboratory Criteria
  188. Epidemiological Criteria
  189. Case Classification
  190. PERTUSSIS
  191. Clinical Criteria
  192. Notes:
  193. Laboratory Criteria
  194. Epidemiological Criteria
  195. Case Classification
  196. PLAGUE
  197. Clinical Criteria
  198. Laboratory Criteria
  199. Epidemiological Criteria
  200. Case Classification
  201. 3.32STREPTOCOCCUS PNEUMONIAE INFECTION, INVASIVE DISEASE
  202. Clinical Criteria
  203. Laboratory Criteria
  204. Case Classification
  205. Antimicrobial resistance:
  206. ACUTE POLIOMYELITIS
  207. Clinical Criteria
  208. Laboratory Criteria
  209. Epidemiological Criteria
  210. Case Classification
  211. Q FEVER
  212. Clinical Criteria
  213. Laboratory Criteria
  214. Epidemiological Criteria
  215. Case Classification
  216. RABIES
  217. Clinical Criteria
  218. Laboratory Criteria
  219. Epidemiological Criteria
  220. Case Classification
  221. RUBELLA
  222. Clinical Criteria
  223. Laboratory Criteria
  224. Epidemiological Criteria
  225. Case Classification
  226. Division
  227. CONGENITAL RUBELLA SYNDROME
  228. Clinical Criteria
  229. Congenital rubella infection (CRI)
  230. Congenital rubella syndrome (CRS)
  231. Laboratory Criteria
  232. Epidemiological Criteria
  233. Case Classification Congenital Rubella
  234. SALMONELLA ENTERITIS
  235. Clinical Criteria
  236. Laboratory Criteria
  237. Division
  238. Epidemiological Criteria
  239. Case Classification
  240. Division
  241. Antimicrobial resistance
  242. SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
  243. Clinical Criteria
  244. Laboratory Criteria
  245. Laboratory criteria for case confirmation
  246. Laboratory criteria for a probable case
  247. Epidemiological Criteria
  248. Case Classification for the inter-epidemic period
  249. Case Classification during an outbreak
  250. SHIGA TOXIN/VEROCYTOTOXIN-PRODUCING E. COLI INFECTION (STEC/VTEC), INCLUDING HAEMOLYTIC-URAEMIC SYNDROME (HUS)
  251. Clinical Criteria
  252. STEC/VTEC diarrhoea
  253. HUS
  254. Laboratory Criteria
  255. Epidemiological Criteria
  256. Case Classification
  257. Division
  258. SHIGELLOSIS
  259. Clinical Criteria
  260. Laboratory Criteria
  261. Division
  262. Epidemiological Criteria
  263. Case Classification
  264. Division
  265. Antimicrobial resistance
  266. SMALLPOX
  267. Clinical Criteria
  268. Laboratory Criteria
  269. Laboratory criteria for case confirmation
  270. Laboratory criteria for a probable case
  271. Epidemiological Criteria
  272. Case Classification
  273. SYPHILIS
  274. Clinical Criteria
  275. Primary syphilis
  276. Secondary syphilis
  277. Early latent syphilis (< 1 year)
  278. Laboratory Criteria
  279. Epidemiological Criteria
  280. Primary/secondary syphilis
  281. Early latent syphilis
  282. Case Classification
  283. CONGENITAL SYPHILIS
  284. Clinical Criteria
  285. Laboratory Criteria
  286. Laboratory criteria for case confirmation
  287. Laboratory criteria for a probable case
  288. Epidemiological Criteria
  289. Case Classification
  290. 3.45TETANUS
  291. Clinical Criteria
  292. Case Classification
  293. TICK-BORNE VIRAL ENCEPHALITIS
  294. Clinical Criteria
  295. Laboratory Criteria
  296. Laboratory criteria for case confirmation:
  297. Laboratory criteria for a probable case:
  298. Epidemiological Criteria
  299. Case Classification
  300. Division
  301. 3.47CONGENITAL TOXOPLASMOSIS
  302. Clinical Criteria
  303. Laboratory Criteria
  304. Case Classification
  305. TRICHINELLOSIS
  306. Clinical Criteria
  307. Laboratory Criteria
  308. Epidemiological Criteria
  309. Case Classification
  310. Division
  311. 3.49TUBERCULOSIS
  312. Clinical Criteria
  313. Laboratory Criteria
  314. Laboratory criteria for case confirmation
  315. Laboratory criteria for a probable case
  316. Case Classification
  317. Antimicrobial resistance
  318. TULARAEMIA
  319. Clinical Criteria
  320. Laboratory Criteria
  321. Epidemiological Criteria
  322. Case Classification
  323. TYPHOID AND PARATYPHOID FEVERS
  324. Clinical Criteria
  325. Laboratory Criteria
  326. Epidemiological Criteria
  327. Case Classification
  328. Division
  329. VIRAL HAEMORRHAGIC FEVERS (VHF)
  330. Clinical Criteria
  331. Laboratory Criteria
  332. Epidemiological Criteria
  333. Case Classification
  334. WEST NILE VIRUS INFECTION (WNV)
  335. Clinical Criteria
  336. Laboratory Criteria
  337. Laboratory test for case confirmation
  338. Laboratory test for a probable case
  339. Epidemiological Criteria
  340. Case Classification
  341. Division
  342. YELLOW FEVER
  343. Clinical Criteria
  344. Laboratory Criteria
  345. Epidemiological Criteria
  346. Case Classification
  347. Division
  348. ENTERITIS DUE TO YERSINIA ENTEROCOLITICA OR YERSINIA PSEUDOTUBERCULOSIS
  349. Clinical Criteria
  350. Laboratory Criteria
  351. Epidemiological Criteria
  352. Case Classification
  353. Division
  354. ZIKA VIRUS DISEASE
  355. Clinical Criteria
  356. Laboratory Criteria
  357. AConfirmed case
  358. BProbable case
  359. Epidemiological Criteria
  360. Case Classification
  361. Division
  362. CONGENITAL ZIKA VIRUS DISEASE
  363. Clinical Criteria
  364. Laboratory Criteria
  365. AConfirmed case
  366. Epidemiological Criteria
  367. Case Classification
  368. CASE DEFINITIONS OF SPECIAL HEALTH ISSUES
  369. 4.1GENERAL CASE DEFINITION OF NOSOCOMIAL INFECTION (OR ‘HEALTHCARE-ASSOCIATED INFECTION (HAI)’)
  370. Division
  371. BJ: Bone and joint infection
  372. BJ-BONE: Osteomyelitis
  373. Note reporting instruction
  374. BJ-JNT: Joint or bursa
  375. BJ-DISC: Disc space infection
  376. BSI: Bloodstream infection
  377. BSI: Laboratory-confirmed bloodstream infection
  378. CNS: Central nervous system infection
  379. CNS-IC: Intracranial infection (brain abscess, subdural or epidural infection, encephalitis)
  380. Note reporting instruction
  381. CNS-MEN: Meningitis or ventriculitis
  382. Note reporting instructions
  383. CNS-SA: Spinal abscess without meningitis
  384. Note reporting instruction
  385. CRI: Catheter-related infection
  386. CRI1-CVC: Local CVC-related infection (no positive blood culture)
  387. CRI1-PVC: Local PVC-related infection (no positive blood culture)
  388. CRI2-CVC: General CVC-related infection (no positive blood culture)
  389. CRI2-PVC: General PVC-related infection (no positive blood culture)
  390. CRI3-CVC: microbiologically confirmed CVC-related bloodstream infection
  391. CRI3-PVC: microbiologically confirmed PVC-related bloodstream infection
  392. CVS: Cardiovascular system infection
  393. CVS-VASC: Arterial or venous infection
  394. Note reporting instructions
  395. CVS-ENDO: Endocarditis
  396. CVS-CARD: Myocarditis or pericarditis
  397. CVS-MED: Mediastinitis
  398. Note reporting instruction
  399. EENT: Eye, ear, nose, throat, or mouth infection
  400. EENT-CONJ: Conjunctivitis
  401. Note reporting instructions
  402. EENT-EYE: Eye, other than conjunctivitis
  403. EENT-EAR: Ear mastoid
  404. EENT-ORAL: Oral cavity (mouth, tongue, or gums)
  405. Note reporting instruction
  406. EENT-SINU: Sinusitis
  407. EENT-UR: Upper respiratory tract, pharyngitis, laryngitis, epiglottitis
  408. GI: Gastrointestinal system infection
  409. GI-CDI: Clostridium difficile infection
  410. GI-GE: Gastroenteritis (excl. CDI)
  411. GI-GIT: Gastrointestinal tract (esophagus, stomach, small and large bowel, and rectum) excluding gastroenteritis and appendicitis
  412. GI-HEP: Hepatitis
  413. Note reporting instructions
  414. GI-IAB: Intraabdominal, not specified elsewhere including gallbladder, bile ducts, liver (excluding viral hepatitis), spleen, pancreas, peritoneum, subphrenic or subdiaphragmatic space, or other intraabdominal tissue or area not specified elsewhere
  415. Note reporting instruction
  416. LRI: Lower respiratory tract infection, other than pneumonia
  417. LRI-BRON: Bronchitis, tracheobronchitis, bronchiolitis, tracheitis, without evidence of pneumonia
  418. Note reporting instruction
  419. LRI-LUNG: Other infections of the lower respiratory tract
  420. Note reporting instruction
  421. NEO: Specific neonatal case definitions
  422. NEO-CSEP: Clinical Sepsis
  423. NEO-LCBI: Laboratory-confirmed BSI
  424. Note reporting instructions
  425. NEO-CNSB: Laboratory-confirmed BSI with coagulase-negative staphylococci
  426. Note reporting instructions
  427. NEO-PNEU: Pneumonia
  428. NEO-NEC: Necrotising enterocolitis
  429. 4.1.10PN: Pneumonia
  430. Notes:
  431. Intubation-associated pneumonia (IAP)
  432. Division
  433. REPR: Reproductive tract infection
  434. REPR-EMET: Endometritis
  435. Note reporting instruction
  436. REPR-EPIS: Episiotomy
  437. REPR-VCUF: Vaginal cuff
  438. Note reporting instruction
  439. REPR-OREP: Other infections of the male or female reproductive tract (epididymis, testes, prostate, vagina, ovaries, uterus, or other deep pelvic tissues, excluding endometritis or vaginal cuff infections)
  440. Note reporting instructions
  441. SSI: Surgical site infection
  442. Division
  443. Superficial incisional (SSI-S)
  444. Deep incisional (SSI-D)
  445. Organ/Space (SSI-O)
  446. SST: Skin and soft tissue infection
  447. SST-SKIN: Skin infection
  448. Note reporting instructions
  449. SST-ST: Soft tissue (necrotizing fascitis, infectious gangrene, necrotizing cellulitis, infectious myositis, lymphadenitis, or lymphangitis)
  450. Note reporting instructions
  451. SST-DECU: Decubitus ulcer, including both superficial and deep infections
  452. SST-BURN: Burn
  453. SST-BRST: Breast abscess or mastitis
  454. SYS: Systemic infection
  455. SYS-DI: Disseminated infection
  456. Note reporting instructions
  457. SYS-CSEP: treated unidentified severe infection
  458. Note reporting instructions
  459. UTI: Urinary tract infection
  460. UTI-A: microbiologically confirmed symptomatic UTI
  461. UTI-B: not microbiologically confirmed symptomatic UTI
  462. GENERAL CASE DEFINITION OF BLOOD STREAM INFECTION DUE TO SPECIFIC PATHOGENS
  463. Clinical criteria
  464. Laboratory criteria
  465. Epidemiological criteria
  466. Case classification
  467. Antimicrobial resistance
  468. GENERIC CASE DEFINITION AND CLASSIFICATION OF ANTIMICROBIAL REISTANCE TO ANTIMICROBIAL AGENTS
  469. Clinical resistance to antimicrobial agents
  470. Definition
  471. Classification
  472. Clinically Susceptible (S)
  473. Clinically Intermediate (I)
  474. Clinically Resistant (R)
  475. Pandrug-resistant (PDR)
  476. Microbiological resistance to antimicrobial agents
  477. Phenotypic definition
  478. Phenotypic classification
  479. Wild-type (WT) phenotype
  480. Non-wild-type (NWT) phenotype
  481. Identification of an acquired antimicrobial resistance mechanism (for example, drug inactivating enzyme, modification of drug target protein type, efflux pump)
  482. Genotypic definition
  483. Genotypic classification