JAC Advance Access originally published online on May 23, 2005
Journal of Antimicrobial Chemotherapy 2005 56(1):60-76; doi:10.1093/jac/dki124
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org
BSAC standardized disc susceptibility testing method (version 4)
Department of Microbiology, City Hospital NHS Trust, Birmingham B18 7QH, UK
* Tel: +44-121-507-5693; Fax: +44-121-507-5521; Email: jenny.andrews@swbh.nhs.uk
Received 1 March 2005; accepted 6 March 2005
Keywords: breakpoints , disc testing , MICs
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Preface |
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In 2002 the BSAC agreed to participate with several other European national groups, namely CA-SFM (Comité de l'Antibiogramme de la Société Française de Microbiologie, France), the CRG (Commissie Richtlijnen Gevoeligheidsbepalingen, The Netherlands), DIN (Deutsches Institut für Normung, Germany), NWGA (Norwegian Working Group on Antimicrobials, Norway) and the SRGA (Swedish Reference Group of Antibiotics, Sweden), in a project to harmonize antimicrobial breakpoints, including previously established breakpoints. This work is being undertaken by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) with the support and collaboration of the national committees, and is funded by the European Union, the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the national committees, including the BSAC. The Clinical and Laboratory Standards Institute (CLSI; formerly the NCCLS) is also in the process of reviewing some breakpoints and has currently agreed to work with EUCAST on breakpoints for cephalosporins in Enterobacteriaceae. The review process includes application
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Introduction |
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1 Preparation of plates |
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2 Selection of control organisms |
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3 Preparation of inoculum |
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3.1 Comparison with 0.5 McFarland standard
3.1.1 Preparation of the McFarland standard. 3.1.2 Inoculum preparation by the growth method (for non-fastidious organisms, e.g. Enterobacteriaceae, Pseudomonas spp. and staphylococci). 3.1.3 Inoculum preparation by the direct colony suspension method (the method of choice for fastidious organisms, e.g. Haemophilus spp., Neisseria gonorrhoeae and Streptococcus pneumoniae). 3.1.4 Adjustment of the organism suspension to the density of the 0.5 McFarland standard. 3.2 Dilution of suspension adjusted to the turbidity of a 0.5 McFarland standard
3.3 Photometric standardization of turbidity of suspensions
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4 Inoculation of agar plates |
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4.1 Use of Rotary platers for susceptibility testing
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5 Antimicrobial discs |
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5.2 Application of discs
5.3 Storage and handling of discs
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6 Incubation |
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6.2 Conditions of incubation
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7 Measuring zones and interpretation |
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8 Direct susceptibility testing |
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8.1 Direct susceptibility testing of urines
8.2 Direct susceptibility testing of positive blood cultures
8.2.1 Gram-negative bacilli. 8.2.2 Gram-positive organisms. 8.2.2.1 Staphylococci and enterococci. 8.2.2.2 Pneumococci, ‘viridans’ streptococci and diptheroids. Appendix 1. Amendments to the MIC and zone diameter breakpoints for ampicillin, amoxicillin and co-amoxiclav for interpreting the susceptibility of Enterobacteriaceae. Review of the zone diameter breakpoints for piperacillin/ tazobactam for interpreting the susceptibility of Enterobacteriaceae. Advice on testing the susceptibility to co-trimoxazole is provided; however, the following are the UK Committee on the Safety of Medicines (CSM) recommendations. Appendix 4. Susceptibility testing H. influenzae to ß-lactam antibiotics.
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