Rationale documents and publications

EUCAST publications in journals

Here you will find EUCAST articles in scientific journals.

Adaptation of Brucella melitensis Antimicrobial Susceptibility Testing to the ISO 20776 Standard and Validation of the Method.

Tscherne A, Mantel E, Boskani T, Budniak S, Elschner M, Fasanella A, Feruglio SL, Galante D, Giske CG, Grunow R, Henczko J, Hinz C, Iwaniak W, Jacob D, Kedrak-Jablonska A, Jensen VK, Johansen TB, Kahlmeter G, Manzulli V, Matuschek E, Melzer F, Nuncio MS, Papaparaskevas J, Pelerito A, Solheim M, Thomann S, Tsakris A, Wahab T, Weiner M, Zoeller L, Zange S; EMERGE AST Working Group. Microorganisms. 2022 Jul 20;10(7):1470. doi: 10.3390/microorganisms10071470.

 

Cefiderocol: EUCAST criteria for disc diffusion and broth microdilution for antimicrobial susceptibility testing. (LINK

Erika Matuschek, Christopher Longshaw, Miki Takemura, Yoshinori Yamano, Gunnar Kahlmeter. Journal of Antimicrobial Chemotherapy.  https://doi.org/10.1093/jac/dkac080
 

How to: ECOFFs – the why, the how and the don´ts of EUCAST epidemiological cutoff values.
G Kahlmeter, J. Turnidge. A narrative review, CMI 2022. 

 

Revisiting colistin susceptibility testing: Will adding calcium to Mueller-Hinton agar improve the detection of colistin resistance?
Supplementary material.
Erika Matuschek, Alma Brolund, Oskar Karlsson Lindsjö, Christian G. Giske, Sara Byfors, Gunnar KahlmeterCMI; April 23, 2021. DOI:https://doi.org/10.1016/j.cmi.2021.04.014

 

Development of a EUCAST disk diffusion method for the susceptibility testing of rapidly growing anaerobic bacteria using Fastidious Anaerobe Agar (FAA) - Development study using Bacteroides species

Herjan Bavelaar, Ulrik Stenz Justesen, Trefor E Morris, Bethan Anderson, Sarah Copsey-Mawer, Tore Taksdal Stubhaug, Gunnar Kahlmeter, Erika Matuschek. Accepted for publication in CMI, April 2021.
 

Comment on: Efficacy of temocillin against MDR Enterobacterales: a retrospective cohort study

Christian G Giske, Gunnar Kahlmeter, Alasdair MacGowan, John Turnidge on behalf of the EUCAST Steering Committee.

Comments on a recently published paper by Alexandre et al. (J Antimicrob Chemother 2021; 76:784-8) which demonstrated good clinical efficacy of temocillin in the treatment of infections originating from the urinary tract. EUCAST agrees with the overall conclusion that temocillin has proven clinical efficacy in infections originating from the urinary tract. However, there are several conclusions in the paper that need further discussion.

After a long review process and public consultation, EUCAST concluded that 2 g × 3 will ensure successful outcomes in all patients with infections originating in the urinary tract. The breakpoints susceptible ≤0.001 mg/L and resistant >16 mg/L avoid dividing the WT of relevant organisms and increase the chance of reproducible susceptibility results. These conclusions are in line with official recommendations both in France and other EU countries where the drug is available.

 

Daptomycin in the treatment of enterococcal bloodstream infections and endocarditis: a EUCAST position paper. CMI 26, P1039-1043, 2020 (https://doi.org/10.1016/j.cmi.2020.04.027). 

J. Turnidge, G. Kahlmeter, R. Cantón, A. MacGowan, C.G. Giske, on behalf of theEuropean Committee on Antimicrobial Susceptibility Testing

Scope: This position paper describes the view adopted by EUCAST on the role of daptomycin in the treatment of serious infections caused by Enterococcus species.

Background: High-dose daptomycin is considered effective in the treatment of enterococcal bloodstream infection (BSI) and endocarditis, although published clinical experience with the latter condition is limited.

Methods: EUCAST reviewed the available published data on pharmacokinetics-pharmacodynamics (PK-PD), resistance selection, clinical efficacy and safety for the use of 10-12 mg/kg/day of daptomycin for these conditions, noting that the doses licensed by the European Medicines Agency are only 4-6 mg/kg/day, and only for infections caused by Staphylococcus aureus.

Findings and recommendations: The PK-PD evidence shows that, even with doses of 10-12 mg/kg/day, it is not possible to treat infections caused by isolates at the upper end of the wild-type distributions of Enterococcus faecalis (with MICs of 4 mg/L) and E. faecium (with MICs of 4 or 8 mg/L). For this reason, and because there are ongoing issues with the reliability of laboratory testing, EUCAST lists daptomycin breakpoints for Enterococcus species as "IE"-insufficient evidence. EUCAST advises increased vigilance in the use of high-dose of daptomycin to treat enterococcal BSI and endocarditis. Additional PK-PD studies and prospective efficacy and safety studies of serious Enterococcal infections treated with high-dose daptomycin may permit the setting of breakpoints in the future.

The relationship between phenotypic and genotypic AST

1st report in CMI from the EUCAST Subcommittee on the role of whole genome sequencing in antimicrobial susceptibility testing. M. J. Ellington et al., CMI 2015. 

  

EUCAST - the 2014 Garrod lecture.

EUCAST – are we heading towards international agreement?

Journal of Antimicrobial Chemotherapy Advance Access published June 18, 2015.
Gunnar Kahlmeter.
 

EUCAST in 2014 - Eurosurveillance

Widespread implementation of EUCAST breakpoints for antibacterial susceptibility testing in Europe.

Eurosurveillance, Volume 20, Issue 2, 15 January 2015.
D Brown, R Cantón, L Dubreuil, S Gatermann, C Giske, A MacGowan, L Martínez-Martínez, J Mouton, R Skov, M Steinbakk, C Walton, O Heuer, M J Struelens, L Diaz Högberg, G Kahlmeter.
 

EUCAST Disk Diffusion

Development of the EUCAST Disk Diffusion Method for antimicrobial susceptibility testing method and its implementation in routine microbiology laboratories.
E. Matuschek, D. F. J. Brown and G. Kahlmeter. Published in CMI 2013

The role of Pk/Pd in setting breakpoints

The role of pharmacokinetics/pharmacodynamics in setting clinical
MIC breakpoints - the EUCAST approach
 (published in CMI 2012)

J. W. Mouton, D. F. J. Brown, P. Apfalter, R. Canton, C. G. Giske, M. Ivanova, A. P. MacGowan, A. Rodloff, C.-J. Soussy, M. Steinbakk and G. Kahlmeter. CMI 2012.

 

EUCAST Expert Rules

EUCAST Expert rules in antimicrobial susceptibility testing.
R. Leclercq, R. Canton, D. F. J. Brown, C. G. Giske, P. Heisig, A. P. MacGowan, J. W. Mouton, P. Nordmann, A. C. Rodloff, G. M. Rossolini, C.-J. Soussy, M. Steinbakk, T. G. Winstanley and G. Kahlmeter. CMI 2012.

 

Echinocandin susceptibility testing of Candida species: comparison of EUCAST EDef 7.1, CLSI M27-A3, Etest, disk diffusion, and agar dilution methods with RPMI and isosensitest media

Arendrup MC, Garcia-Effron G, Lass-Flörl C, Lopez AG, Rodriguez-Tudela JL, Cuenca-Estrella M, Perlin DS. Antimicrob Agents Chemother 2010; 54: 426-39
link to full article

EUCAST breakpoints for antifungals

Rodriguez-Tudela JL, Arendrup MC, Cuenca-Estrella M, Donnelly JP, Lass-Florl C. Drug News Perspect 2010; 23: 93-7
link to full article

Association of fluconazole pharmacodynamics with mortality in patients with candidemia

Arendrup MC, Cuenca-Estrella M, Donnelly JP, Lass-Flörl C, Rodriguez-Tudela JL. Antimicrob Agents Chemother 2009; 53: 2704-5
link to full article

Data mining validation of fluconazole breakpoints established by the European Committee on Antimicrobial Susceptibility Testing

Cuesta I, Bielza C, Larrañaga P, Cuenca-Estrella M, Laguna F, Rodriguez-Pardo D, Almirante B, Pahissa A, Rodríguez-Tudela JL. Antimicrob Agents Chemother 2009; 53: 2949-54
link to full article

Breakpoints for susceptibility testing should not divide wild-type distributions of important target species

Arendrup MC, Kahlmeter G, Rodriguez-Tudela JL, Donnelly JP. Antimicrob Agents Chemother 2009; 53:1628-9.
link to full article

Susceptibility testing of Candida species to echinocandins: comparison of EUCAST EDef 7.1, CLSI M27-A3, Etest, disk diffusion and agar-dilution using RPMI and IsoSensitest medium

Arendrup MC, Garcia-Effron G, Lass-Floerl C, Gomez Lopez A, Rodriguez-Tudela JL, Cuenca-Estrella M, Perlin DS. Antimicrob Agents Chemother. 2009 Nov 2. Epub ahead of print.
Link to full article

Method for the determination of broth dilution of antifungal agents for fermentative yeasts, Apr 2008

Subcommittee on Antifungal Susceptibility Testing (ASFT) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST), EUCAST Definitive Document E.DEF 7.1: method for the determination of broth dilution of antifungal agents for fermentative yeasts. CMI 2008; 14:398-405.

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Antimicriobial susceptibility testing of Mycobacterium tuberculosis, Dec 2007

Drobniewski F, Rüsch-Gerdes S, Hoffner S. EUCAST document E.DEF 8.1: antimicrobial susceptibility testing of Mycobacterium tuberculosis - Report of the Subcommittee on Antimicrobial Testing of Mycobacterium tuberculosis of the European Committee for Antimicrobial Susceptibility Testing (EUCAST) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). CMI 2007; 13:1144-56.

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Comparison of EUCAST-AFST and CLSI methods for susceptibility testing of posaconazole and voriconazole against Aspergillus spp., Sep 2006

Chryssanthou E and Cuenca-Estrella M (2006) Comparison of the EUCAST-AFST broth dilution method with the CLSI reference broth dilution method (M38-A) for susceptibility testing of posaconazole and voriconazole against Aspergillus spp.  Clin Microbiol Infect; 12:901-904.

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Editorial - EUCAST technical notes on antimicrobial susceptibility testing

Kahlmeter G, Brown DFJ, Goldstein FW, et al. Editorial: European Committee on Antimicrobial Susceptibility Testing (EUCAST). CMI 2006; 12:501-503.

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Harmonisation of antimicrobial breakpoints in Europe – can it be achieved?, 2004

Kahlmeter G, Brown DFJ. (2004) Harmonisation of antimicrobial breakpoints in Europe – can it be achieved?. Clinical Microbiology Newsletter 2004; 26:187-192.

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European harmonization of MIC breakpoints for antimicrobial susceptibility testing of bacteria, 2003

Kahlmeter G, Brown DFJ, Goldstein FW et al. European harmonization of MIC breakpoints for antimicrobial susceptibility testing of bacteria.
J Antimicrob Chemother 2003; 52:145-148.

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Determination of minimum inhibitory concentrations (MICs) of antibacterial agents by broth dilution, March 2003

European Committee for Antimicrobial Susceptibility Testing (EUCAST) of the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). EUCAST Discussion Document E. Dis 5.1: determination of minimum inhibitory concentrations (MICs) of antibacterial agents by broth dilution. Clin Microbiol Infec 2003; 9 (insert): 1-7.
Link to full document

 

This discussion document was not developed into a EUCAST definitive document because EUCAST was aware of the proposed development of an international (ISO) standard for broth microdilution, which was eventually published in 2006.

Determination of antimicrobial susceptibility test breakpoints, Aug 2000

European Committee for Antimicrobial Susceptibility Testing (EUCAST) of the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). EUCAST Definitive Document E. Def 2.1: determination of antimicrobial susceptibility test breakpoints. Clin Microbiol Infec 2000; 6:570-572.

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Determination of minimum inhibitory concentrations (MICs) of antibacterial agents by agar dilution, Jun 2000

European Committee for Antimicrobial Susceptibility Testing (EUCAST) of the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). EUCAST Definitive Document E. Def 3.1: determination of minimum inhibitory concentrations (MICs) of antibacterial agents by agar dilution. Clin Microbiol Infec 2000; 6:509-515.

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Terminology relating to methods for the determination of susceptibility of bacteria to antimicrobial agents, May 2000

EUCAST Definitive Document E.Def 1.2: terminology relating to methods for the determination of susceptibility of bacteria to antimicrobial agents. Clin Microbiol Infec 2000; 6:503-508.

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