Abstract
The European Committee on Antimicrobial Susceptibility Testing (EUCAST) was established to harmonise clinical antimicrobial breakpoints and to define breakpoints for new agents in Europe. Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) external quality assessment (EQA) exercises from 2009 to 2012, from the United Kingdom External Quality Assessment Scheme (UK NEQAS) from November 2009 to March 2013 and data collected by EUCAST through a questionnaire in the first quarter of 2013 were analysed to investigate implementation of EUCAST guidelines in Europe. A rapid change to use of EUCAST breakpoints was observed over time. Figures for implementation of EUCAST breakpoints at the end of the studied period were 61.2% from EARSNet data and 73.2% from UK NEQAS data. Responses to the EUCAST questionnaire indicated that EUCAST breakpoints were used by over 50% of laboratories in 18 countries, by 10 to 50% of laboratories in eight countries and by less than 10% in seven countries. The EUCAST disk diffusion method was used by more than 50% of laboratories in 12 countries, by 10 to 50% of laboratories in ten countries and by less than 10% in eleven countries. EUCAST guidelines implementation is essential to ensure consistent clinical reporting of antimicrobial susceptibility results and antimicrobial resistance surveillance.
Highlights
The use of common clinical breakpoints for antimicrobial susceptibility testing is important both for consistent clinical reporting of antimicrobial susceptibility and for international surveillance of the antimicrobial susceptibility of microorganisms
European Committee on Antimicrobial Susceptibility Testing (EUCAST) questionnaire on guidelines and methods used in different countries In the first quarter of 2013, a questionnaire was distributed to all General Committee members with the objective of collecting information on whether EUCAST breakpoint guidelines were followed, adoption of the EUCAST disk diffusion method and whether the country has a national antimicrobial susceptibility committee (NAC) as recommended by EUCAST [14]
Table Antimicrobial susceptibility testing guidelines used by laboratories participating in the EARS-Net external quality assessment (EQA) exercises, 2009–2012 and UK NEQAS for antimicrobial susceptibility testing, 2009–2013
Summary
The use of common clinical breakpoints for antimicrobial susceptibility testing is important both for consistent clinical reporting of antimicrobial susceptibility and for international surveillance of the antimicrobial susceptibility of microorganisms. Complete data on uptake in all European laboratories are not available as in most countries there is no mechanism for collection of information on susceptibility testing guidelines followed. The external quality assessment (EQA) exercise that is part of the European Antimicrobial Resistance Surveillance Network (EARS-Net) [8] organised by ECDC though a framework contract with the UK National External Quality Assessment Scheme (UK NEQAS). EUCAST questionnaire on guidelines and methods used in different countries In the first quarter of 2013, a questionnaire was distributed to all General Committee members with the objective of collecting information on whether EUCAST breakpoint guidelines were followed, adoption of the EUCAST disk diffusion method and whether the country has a national antimicrobial susceptibility committee (NAC) as recommended by EUCAST [14]. The categories provided were below 10%, 10 to 50% and above 50% of laboratories
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