PMID: 9435026Jan 1, 1997Paper

Antimicrobial susceptibility testing in Sweden. II. Species-related zone diameter breakpoints to avoid interpretive errors and guard against unrecognized evolution of resistance

Scandinavian Journal of Infectious Diseases. Supplementum
S RingertzG Kronvall

Abstract

The Swedish Reference Group for Antibiotics appointed a subcommittee on methodology (SRGA-M) in 1987 to investigate ways of defining interpretive breakpoints for antimicrobial susceptibility testing. The minimum inhibitory concentration (MIC) breakpoints for susceptibility categories are mainly based on pharmacological properties of the antibiotic, and they are, with few exceptions, valid for all species. However, for several species the MIC breakpoints have failed to distinguish strains with reduced susceptibility from normal susceptible strains. Disk diffusion is the routine method for susceptibility testing in Sweden. Studies of distribution of MICs and zone diameters for clinically important bacterial species have resulted in an emphasis on resistance rather than on susceptibility. The SRGA-M chose to place the zone diameter breakpoints close to the native (often susceptible) population of each species or group of related species. Such species-related zone diameter breakpoints used for susceptibility categories no longer correspond to the pharmacological MIC breakpoints, but divide each species into the fully susceptible (native) population and into those isolates/populations that have acquired a resistance mechanism, resul...Continue Reading

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