Division 4.2 Analytical methods for detection and antimicrobial susceptibility testing
United Kingdom
Member States shall use the epidemiological cut-off values and the concentration ranges set out in Tables 2, 3 and 4 below to determine the antimicrobial susceptibility of Salmonella spp., C. coli, C. jejuni, indicator commensal E. coli, E. faecalis and E. faecium.
Any E. coli and Salmonella isolate tested in accordance with Table 2 showing resistance to cefotaxime or ceftazidime or meropenem shall be further tested with a second panel of antimicrobial substances in accordance with Table 5.
For the specific monitoring of ESBL-, AmpC- and/or CP-producing E. coli, Member States shall use the methods referred to in point 5.
The antimicrobial susceptibility testing shall be performed by the laboratories referred to in Article 3(2). The testing shall be performed by using the broth micro dilution method according to the reference method ISO 20776-1:2019.
Table 2
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)
| tentative EUCAST threshold | |||||
| NA: not available. | |||||
| Antimicrobial | Class of antimicrobial | Species | Interpretative thresholds of AMR (mg/L) | Range of concentrations (mg/L)(No of wells in brackets) | |
|---|---|---|---|---|---|
| ECOFF | Clinical breakpoint | ||||
| Amikacin | Aminoglycoside | Salmonella | > 4f1 | > 16 | 4-128 (6) |
| E. coli | > 8 | > 16 | |||
| Ampicillin | Penicillin | Salmonella | > 8 | > 8 | 1-32 (6) |
| E. coli | > 8 | > 8 | |||
| Azithromycin | Macrolide | Salmonella | NA | NA | 2-64 (6) |
| E. coli | NA | NA | |||
| Cefotaxime | Cephalosporin | Salmonella | > 0,5 | > 2 | 0,25-4 (5) |
| E, coli | > 0,25 | > 2 | |||
| Ceftazidime | Cephalosporin | Salmonella | > 2 | > 4 | 0,25-8 (6) |
| E, coli | > 0,5 | > 4 | |||
| Chloramphenicol | Phenicol | Salmonella | > 16 | > 8 | 8-64 (4) |
| E, coli | > 16 | > 8 | |||
| Ciprofloxacin | Fluoroquinolone | Salmonella | > 0,06 | > 0,06 | 0,015-8 (10) |
| E, coli | > 0,06 | > 0,5 | |||
| Colistin | Polymyxin | Salmonella | NA | > 2 | 1-16 (5) |
| E, coli | > 2 | > 2 | |||
| Gentamicin | Aminoglycoside | Salmonella | > 2 | > 4 | 0,5-16 (6) |
| E, coli | > 2 | > 4 | |||
| Meropenem | Carbapenem | Salmonella | > 0,125 | > 8 | 0,03-16 (10) |
| E, coli | > 0,125 | > 8 | |||
| Nalidixic acid | Quinolone | Salmonella | > 8 | NA | 4-64 (5) |
| E, coli | > 8 | NA | |||
| Sulfamethoxazole | Folate pathway antagonist | Salmonella | NA | NA | 8-512 (7) |
| E, coli | > 64 | NA | |||
| Tetracycline | Tetracycline | Salmonella | > 8 | NA | 2-32 (5) |
| E, coli | > 8 | NA | |||
| Tigecycline | Glycylcycline | Salmonella | NA | NA | 0,25-8 (6) |
| E, coli | > 0,5 | > 0,5 | |||
| Trimethoprim | Folate pathway antagonist | Salmonella | > 2 | > 4 | 0,25-16 (7) |
| E, coli | > 2 | > 4 | |||
Table 3
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
| NA: not available | |||||
| Antimicrobial | Class of antimicrobial | Species | Interpretative thresholds of AMR (mg/L) | Range of concentrations (mg/L)(No of wells in brackets) | |
|---|---|---|---|---|---|
| ECOFF | Clinical breakpoint | ||||
| Chloramphenicol | Phenicol | C. jejuni | > 16 | NA | 2-64 (6) |
| C. coli | > 16 | NA | |||
| Ciprofloxacin | Fluoroquinolone | C. jejuni | > 0,5 | > 0,5 | 0,12-32 (9) |
| C. coli | > 0,5 | > 0,5 | |||
| Ertapenem | Carbapenem | C. jejuni | NA | NA | 0,125-4 (6) |
| C. coli | NA | NA | |||
| Erythromycin | Macrolide | C. jejuni | > 4 | > 4 | 1-512 (10) |
| C. coli | > 8 | > 8 | |||
| Gentamicin | Aminoglycoside | C. jejuni | > 2 | NA | 0,25-16 (7) |
| C. coli | > 2 | NA | |||
| Tetracycline | Tetracycline | C. jejuni | > 1 | > 2 | 0,5-64 (8) |
| C. coli | > 2 | > 2 | |||
Table 4
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
| NA: not available | |||||
| Antimicrobial | Class of antimicrobial | Species | Interpretative thresholds of AMR (mg/L) | Range of concentrations (mg/L)(No of wells in brackets) | |
|---|---|---|---|---|---|
| ECOFF | Clinical breakpoint | ||||
| Ampicillin | Penicillin | E. faecalis | > 4 | > 8 | 0,5-64 (8) |
| E. faecium | > 4 | > 8 | |||
| Chloramphenicol | Phenicol | E. faecalis | > 32 | NA | 4-128 (6) |
| E. faecium | > 32 | NA | |||
| Ciprofloxacin | Fluoroquinolone | E. faecalis | > 4 | > 4 | 0,12-16 (8) |
| E. faecium | > 4 | > 4 | |||
| Daptomycin | Lipopeptide | E. faecalis | > 4 | NA | 0,25-32 (8) |
| E. faecium | > 8 | NA | |||
| Erythromycin | Macrolide | E. faecalis | > 4 | NA | 1-128 (8) |
| E. faecium | > 4 | NA | |||
| Gentamicin | Aminoglycoside | E. faecalis | > 64 | NA | 8-1 024 (8) |
| E. faecium | > 32 | NA | |||
| Linezolid | Oxazolidinone | E. faecalis | > 4 | > 4 | 0,5-64 (8) |
| E. faecium | > 4 | > 4 | |||
| Quinupristin/Dalfopristin | Streptogramin | E. faecalis | NA | NA | 0,5-64 (8) |
| E. faecium | NA | > 4 | |||
| Teicoplanin | Glycopeptide | E. faecalis | > 2 | > 2 | 0,5-64 (8) |
| E. faecium | > 2 | > 2 | |||
| Tetracycline | Tetracycline | E. faecalis | > 4 | NA | 1-128 (8) |
| E. faecium | > 4 | NA | |||
| Tigecycline | Glycylcycline | E. faecalis | > 0,25 | > 0,25 | 0,03-4 (8) |
| E. faecium | > 0,25 | > 0,25 | |||
| Vancomycin | Glycopeptide | E. faecalis | > 4 | > 4 | 1-128 (8) |
| E. faecium | > 4 | > 4 | |||
Annotations
Footnotes
- f1
-
tentative EUCAST threshold