National Antimicrobial Susceptibilty Testing Committees (NAC)
EUCAST recommends that countries institute a “National antimicrobial Susceptibility Testing Committee” (or a committee corresponding to this description). Countries in the process of adopting EUCAST antimicrobial susceptibility testing guidelines will find this particularly useful during the implementation process. The chairperson, or another committee officer, should represent the country on the EUCAST General Committee.
This document presents EUCAST suggestions on How to organise and form a NAC.
NACs are invited to provide a link to their website for EUCAST to post here.
List of and brief information on National breakpoint committees and NACs:
The National AST Committee was established in mid-2011 under the auspices of the Australian Society for Antimicrobials to provide expert advice and further the cause of skill development in the area of antimicrobial susceptibility testing. Until now, there has been no entity undertaking this task, although matters have often been referred to the Executive of the Australian Group on Antimicrobial Resistance (AGAR), a federally funded resistance surveillance group ran through the financial auspices of ASA.
Membership: the inaugural membership comprises medical microbiologists and clinical laboratory scientists, currently under the chairmanship of John Turnidge, Adelaide.
Terms of reference include:
• Provide expert advice to laboratories and other stakeholders Australia-wide on all aspects of susceptibility testing (principally for but not necessarily restricted to antibacterial and antifungals)
• Provide advice to device manufacturers on preferred testing ranges and other aspects of devices and supplies as requested or required for the Australian environment
• Assist laboratories in transitioning from CLSI to EUCAST methods and breakpoints (where available)
• Provide advice to resistance surveillance groups on laboratory methods, testing concentrations, and interpretation of data relevant to the type of resistance surveillance being undertaken
• Run educational workshops on basic and advanced aspects of susceptibility testing
• Liaise with international standards setting bodies such as EUCAST and CLSI
Meetings: Initially, the NAC will meet face-to-face twice yearly in conjunction with the biannual ASA/AGAR, with work being undertaken in between meeting via email and teleconference.
British Society for Antimicrobial Chemotherapy (BSAC)
The British Society for Antimicrobial Chemotherapy (BSAC) was established on 26 August 1971 "to facilitate the acquisition and dissemination of knowledge in the field of antimicrobial chemotherapy". Antimicrobial susceptibility testing has been a major interest from the first meeting and a specialist Antimicrobial Susceptibility Testing Working Party was formed in 1985. The first chairman of the BSAC was William Brumfitt, and the first chairman of the Antimicrobial Susceptibility Testing working party was Ian Phillips. The working party meets 3-4 times per year and comprises 10-15 members, currently including medical microbiologists, clinical scientists and veterinary scientists.
Committé Antibiogramme - Société Française de Microbiologie (CA-SFM)
CA-SFM was founded in 1980. It is composed of twenty members (clinical microbiology, pharmacology, and infectious diseases) and has three meetings annually. Special working parties have dealt with particular issues. The primary role of CA-SFM has been to propose breakpoints but also to establish rules of interpretation of the “antibiogramme”, taking into account an in-depth knowledge of the accepted mechanisms of resistance and of the technical procedures for their detection. These rules have been discussed and developed under French leadership in the EUCAST expert rules subcommittee.
CA-SFM is linked to the Medicines French Agency (AFSSAPS) for establishment of the spectrum of activity of antibiotics. The recommendations of CA-SFM have been published in a “Communiqué” annually revised and updated.
CA-SFM belongs to the Steering Committee and the General Committees of EUCAST and actively participates to their work.
DIN Deutsches Institut für Normung e.V. (DIN)
The German Institute for Standardization was founded in 1917. It is often thought that it standardizes technical products only, but it also has branch that addresses all kinds of medical issues and devices. The working group on susceptibility testing was founded in the early 1970s and consists of up to 21 members coming from stake holders from the universities, the medical care providers and the pharmaceutical industry. Most members have a background in clinical microbiology or infectious diseases. Prof. GötzLinzenmeyer†, MD was the first chair-holder, who was followed in 1988 by Prof. Arne Rodloff, MD. Over the years, the working group has published DIN standards on broth macro- and microdilution, agardilution, disk diffusion, preparation of disks, regression analysis, breakpoints and quality control. Most of them are available in German and English. Non- fastidious and fastidious bacteria were addressed as well as anaerobes and fungi. The DIN working group took the lead in a CEN initiative that finally resulted in the ISO standards 20776-1 and 2, the first world wide standards on susceptibility testing.
Dutch Working Group on Antibiotics (SWAB)
The Dutch Committee on Susceptibility testing (CRG, Commissie Richtlijnen Gevoeligheidsbepalingen, formerly WRG) was established in 1971 to develop methodology in antimicrobial susceptibility testing and define clinical breakpoints and critical zone diameters. The first chairman was R. Peter Mouton and the secretary B. van Klingeren. He was succeeded by J. Degener and Johan W. Mouton, who is the current chair. As of 2010, the CRG is a subcomittee of the SWAB, the Dutch Working Party on Antibiotic Policy (www.swab.nl). The number of committee members in the group varied but was typically 10 and consisted of specialists in clinical microbiology, infectious diseases, pediatrics and clinical pharmacology. Breakpoints and critical zone diameters were originally published as reports and in later years in the Journal of the Dutch Society of Medical Microbiology (www.nvmm.nl).
Norwegian Working Group on Antibiotics (NWGA)
The Norwegian Working Group on Antibiotics (NWGA; in Norwegian Arbeidsgruppen for antibiotikaspørsmål - AFA), was formed in 1978 and consisted of four specialists in clinical microbiology and two specialists in infectious diseases, appointed by the respective specialist committees in the Norwegian Medical Association. In 2005 NWGA became an official advisory expert group for the Norwegian Directorate of Health and the group was expanded to nine members and the Institute of Veterinary Medicine and the Norwegian Medicines Agency appointed observers. NWGA establish national guidelines for antimicrobial susceptibility testing (bacteria and fungi). This work is performed in close collaboration with other Scandinavian countries and follows EUCAST recommendations. NWGA also arrange national bi-annual courses (practical and theoretical) in antimicrobial susceptibility testing.
Swedish Reference Group for Antibiotics (SRGA)
The Swedish Reference Group of Antibiotics (SRGA; in Swedish Referensgruppen för Antibiotikafrågor, RAF), was formed in 1976 as a breakpoint committee. In 1986 a subcommittee on methodology and quality assurance was formed (SRGA-M), and SRGA took on more antibiotic policy issues. The first chairman of SRGA was Lars-Olof Kallings and of SRGA-M Gunnar Kahlmeter. The number of committee members in the respective groups varied but was typically 10 in each group. SRGA consisted of specialists in clinical microbiology, infectious diseases, pediatrics, clinical pharmacology, otorhinolaryngology and later also primary care medicine. Both groups are still active. They share a website.
Swiss Society for Microbiology
