Table 2 |
Non-species related breakpoints |
Enterobac- teriaceae |
Pseudo- monas |
Acineto- bacter |
Staphylo- coccus |
Entero- coccus |
Strepto- coccus |
S.pneu- moniae |
Other
strepto cocci# |
H.influ- enzae |
M.ca- tarrhal |
C.ureal C.jeikei |
N.gonor- rhoeae |
N.menin- gitidis |
Anaerobe, Grampositive |
Anaerobe, Grampositive |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Method: | A | A | A | A | A | B | B | B | B | B | B | Footnote | B |
B |
B |
|
| Amikacin | 8/16 | 8/16 | 8/16 | 8/16 | 8/16 | ent | strep | -- | IE | IE | -- | -- | -- | -- | -- | |
| Gentamicin | 2/4 | 2/4 | 4/4 | 4/4 | 1/1 | ent | strep | -- | IE | IE | -- | -- | -- | -- | -- | |
| Netilmicin | 2/4 | 2/4 | 4/4 | 4/4 | 1/1 | ent | strep | -- | IE | IE | -- | -- | -- | -- | -- | |
| Tobramycin | 2/4 | 2/4 | 4/4 | 4/4 | 1/1 | ent | strep | -- | IE | IE | -- | -- | -- | -- | -- | |
| Erythromycin | IE | -- | -- | -- | 1/2 | -- | 0.25/0.5 | 0.25/0.5 | 0.5/16 |
0.25/0.5 |
IE | -- | -- | -- | -- | |
| Roxithromycin | IE | -- | -- | -- | 1/2 | -- | 0.5/1 | 0.5/1 | 1/16 | 0.5/1 | IE | -- | -- | -- | -- | |
| Klarithromycin | IE | -- | -- | -- | 1/2 | -- | 0.25/0.5 | 0.25/0.5 | 1/32 | 0.25/0.5 | IE | -- | -- | -- | -- | |
| IE | -- | -- | -- | 1/2 | -- | 0.25/0.5 | 0.25/0.5 | 0.12/4 |
0.5/0.5 |
IE | 0.25/0.5 | -- | -- | -- | ||
| IE | -- | -- | -- | IE | -- | 0.25/0.5 | 0.25/0.5 | 0.12/8 | 0.25/0.5 | -- | -- | -- | -- | -- | ||
| IE | -- | -- | -- | 0.25/0.5 | -- | 0.5/0.5 | 0.5/0.5 | -- | -- | IE | -- | -- | 4/4 | 4/4 | ||
| Fusidic acid | 0.5/0.5 | -- | -- | -- | 0.5/0.5 | -- | IE | IE | -- | -- | 0.5/0.5 | -- | -- | |||
| Fusidic acid | IE | -- | -- | -- | 1/1 | -- | IE | -- | -- | -- | -- | -- | -- | -- | -- | |
| Kloramfenikol | 8/8 | 8/8 | -- | -- | 8/8 | -- | -- | (8/8) | 2/2 | -- | IE | -- | 2/8 | |||
| Chloramphenicol | IE | 8/8 | -- | -- | 8/8 | -- | 8/8 | 8/8 | 1/2 | 1/2 | -- | -- | 2/4 | 8/8 | 8/8 | |
| Doxycyklin | (2/2) | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | |||
| Doxycyklin | IE | -- | -- | -- | 1/2 | -- | 1/2 | 1/2 | 1/2 | 1/2 | -- | IE | -- | -- | -- | |
| Tetracyklin | 2/2 | -- | -- | -- | 2/2 | IE | 2/2 | 2/2 | 2/2 | 2/2 | -- | 0.12/1 | -- | |||
| Tetracyklin | IE | -- | -- | -- | 1/2 | -- | 1/2 | 1/2 | 1/2 | 1/2 | -- | IE | IE | -- | -- | |
| Tigecyklin | 0.25/0.5 | 1/2 | -- | IE | 0.5/0.5 | 0.25/0.5 | 0.25/0.5 | IE | IE | IE | IE | IE | IE | -- | -- | |
|
Non-species related breakpoints |
Enterobac- teriaceae |
Pseudo- monas |
Acineto- bacter |
Staphylo- coccus |
Entero- coccus |
Strepto- coccus |
S.pneu- moniae |
Other
strepto cocci# |
H.influ- enzae |
M.ca- tarrhal |
C.ureal C.jeikei |
N.gonor- rhoeae |
N.menin- gitidis |
Anaerobes, grampositive |
Anaerobes, gramnegative |
|
| Rifampicin | 1/1 | -- | -- | -- | 1/1 | -- | 1/1 | 1/1 | -- | -- | IE | -- | 1/1 (Prophylaxis) |
|||
| Rifampicin | IE | -- | -- | -- | 0.06/0.5 | -- | 0.06/0.5 | 0.06/0.5 | 0.5/0.5 | IE | IE | -- | 0.25/0.25(Prophylaxis) | -- | -- | |
| 4/8 | -- | -- | -- | 4/8** | 4/8 | 4/4 | 4/4 | -- | -- | IE | -- | -- | -- | -- | ||
| 4/8 | -- | -- | -- | 4/8** | 4/8 | 4/4 | 4/4 | -- | -- | IE | -- | -- | -- | -- | ||
| Linezolid* | 2/4 | -- | -- | -- | 4/4 | 4/4 | 2/4 | 2/4 | -- | -- | IE | -- | -- | -- | -- | |
| Daptomycin* | IE | -- | -- | -- | 1/1** | IE | 1/1** | IE | -- | -- | -- | -- | -- | -- | -- | |
| IE | -- | -- | -- | 1/2 |
E.faecalis: R E.faecium: 1/4 |
-- | -- | -- | -- | -- | -- | -- | -- | -- | ||
| Metronidazole | 4/4 | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | |||
| Metronidazole | IE | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 4/4 | 4/4 | |
| Norfloxacin (U) | 0.5/1 | 0.5/1 | -- | -- | -- | -- | -- | -- | -- | -- | -- | IE | -- | -- | -- | |
| Ciprofloxacin | 0.5/1 | 0.5/1 | 0.5/1 | 1/1 | 1/1 | -- | -- | 0.12/2 | 0.5/0.5 | 0.5/0.5 | IE | 0.03/0.06 | 0.03/0.06 (Prophylaxis) |
-- | -- | |
| Ofloxacin | 0.5/1 | 0.5/1 | -- | -- | 1/1 | -- | -- | 0.12/4 | 0.5/0.5 | 0.5/0.5 | -- | 0.12/0.25 | IE | -- | -- | |
| Levofloxacin | 1/2 | 1/2 | 1/2 | 1/2 | 1/2 | -- | 1/2 | 2/2 | 1/1 | 1/1 | IE | IE | IE | -- | -- | |
| Moxifloxacin | 0.5/1 | 0.5/1 | -- | -- | 0.5/1 | -- | 0.5/1 | 0.5/0.5 | 0.5/0.5 | 0.5/0.5 | IE | IE | IE | -- | -- | |
| Nitrofurantoin | 32/32 | 32/32 | -- | 32/32 | 32/32 |
E.faecalis:
32/32 E.faecium: R |
32/32 | -- | -- | -- | -- | -- | -- | -- | ||
| Nitrofurantoin (U) | IE | 64/64 | -- | -- | 64/64 | 64/64 | 64/64 | -- | -- | -- | -- | -- | -- | -- | -- | |
| Trimetoprim | 2/4 | 2/4 | -- | -- | 2/4 | 2/4 | 2/4 | -- | -- | -- | IE | -- | -- | |||
| Trimethoprim (U) | IE | 2/4 | -- | -- | 2/4 | 0.032/1 | -- | -- | -- | -- | -- | -- | -- | -- | -- | |
| TrimSulfa | 16/32 | 16/32 | -- | 16/32 | 16/32 | -- | 16/32 | 16/32 | 16/32 | 16/32 | IE | -- | -- | |||
| TrimSulfa (ratio 1:19) | IE | 2/4 |
Pseudo-monas: -- S.maltophilia: 4/4 |
2/4 | 2/4 | 0.032/1 | 1/2 | 1/2 | 0.5/1 | 0.5/1 | IE | -- | -- | -- | -- | |
| Colistin | 2/2 | 2/2 | 2/2 | 2/2 | -- | -- | -- | -- | -- | -- | -- | -- | -- | |||
| Colistin* | IE | 2/2 | 2/2 | 2/2 | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | |
| Fosfomycin-trometamol(U) | IE | 32/32 | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | |
| Spectinomycin | 32/32 | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 32/32 | -- | |||
| Spectinomycin* | IE | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | 64/64 | -- | -- | -- |
#Other streptococci -
breakpoints to follow. Meanwhile use Streptococcus A, B, C, G.
| Listeria Method B |
Penicillin G (2/2), Ampicillin (2/2), Meropenem (0.5/0.5), TrimSulfa (2/4). Vid allergi hos gravida Erythromycin (0.5/0.5) som har sämre klinisk effekt. EUCAST MIC-distributions for Listeria monocytogenes. |
| P.multocida Method B |
Penicillin V (0.5/0.5), Ampicillin (0.5/0.5), Cefotaxime (0.12/1), Ciprofloxacin (0.12/0.25), Tetracycline (2/4) och TrimSulfa (2/4). EUCAST MIC-distributions for P.multocida. |
| H.pylori Method B |
Ampicillin (0.5/1), Clarithromycin (0.25/0.25), Tetracycline (2/2), Metronidazole (4/4). EUCAST MIC-distributions for H. pylori. |
| Legionella pneumophila | See MIC-distributions for relevant antimicrobials. |
|
Stenotrophomonas
maltophilia** |
Breakpoints for
antimicrobials other than trimethoprimsulfamethoxazole are not given by SRGA or EUCAST. Clinical correlation between
MIC-values and clinical outcome is lacking and testing is uncertain. EUCAST MIC-distributions for Stenotrophomonas maltophilia. |
|
*Isolat med MIC-värden över S/I-brytpunkten är
ovanliga eller har ännu inte beskrivits. Identifiering och
resistensbestämning skall upprepas och om resultatet konfirmeras skickas
isolatet till referenslaboratorium **MIC-bestämning på MH-medium. (U) Brytpunkterna gäller endast vid nedre okomplicerad urinvägsinfektion. |
*Isolates with MIC values above the S/I-breakpoint are very rare or not yet reported. The identification and antimicrobial susceptibility tests on any such isolate must be repeated and if the result is confirmed the isolate sent to a reference laboratory. **MIC-determination on MH only. (U) = Breakpoints valid for uncomplicated urinary tract infections only. |
|
*Isolat med MIC-värden över S/I-brytpunkten är
ovanliga eller har ännu inte beskrivits. Identifiering och
resistensbestämning skall upprepas och om resultatet konfirmeras skickas
isolatet till referenslaboratorium **MIC-bestämning på MH-medium. (U) = Urinvägsinfektioner. |
*Isolates with MIC values above the S/I-breakpoint are very rare or not yet reported. The identification and antimicrobial susceptibility tests on any such isolate must be repeated and if the result is confirmed the isolate sent to a reference laboratory. **MIC-determination on MH only. (U) = Urinary tract infections only. |
Kursiv text anger en länk till en fotnot. För den som skriver ut tabellen på papper är det viktigt att även alla fotnoter skrivs ut och följer med tabellen. |
Text = a link to a footnote. If you print the table on paper, remember to print the footnotes - they contain important information on methodology. |
| MIC-gränser
angivna som exempelvis 4/8, skall tolkas S<
4 och R>8 mg/l. IE - Klinisk effekt utesluts ej men in vitro och/eller in vivo dokumentation saknas. -- RAF avråder från resistensbestämning. Ej relevant behandlingsalternativ:
Proph - endast för profylax |
Breakpoints
given as 4/8, should be interpretated as S<
4 mg/l and R>8 mg/l. IE - Clinical effect is not ruled out but EUCAST has not been able to find enough evidence to make a breakpoint decision. -- SRGA advices against susceptibility testing. Not a relevant alternative:
Proph - prophylaxis only |
|
Metod: A = grundmedium utan tillsatser. Inkubation i luft, 35o C. B = grundmedium + 5% skakhästblod + NAD. Inkubation 35o C i 5 % CO2. |
Method: A = medium without additives. Incubation in air, 35o C. B = medium + 5% defibrinated horse blood + NAD. Incubation at 35o C in 5 % CO2. |