by author ESCMID Online Lecture Library Implementation of EUCAST antimicrobial susceptibility testing methods Gunnar Kahlmeter, Derek Brown

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1 Implementation of EUCAST antimicrobial susceptibility testing methods Gunnar Kahlmeter, Derek Brown Izmir, February 2011

2 Implementation of EUCAST antimicrobial susceptibility testing methods EUCAST National action Local (NAC) laboratories

3 Implementation of EUCAST antimicrobial susceptibility testing methods National implementation (GK) Countries that have adopted EUCAST MIC breakpoints Countries that have adopted EUCAST Disk Diffusion methodology Countries that have formed NACs Automated systems that have implemented EUCAST breakpoints EUCAST action -documentation and education (DB) Local implementation of disk diffusion (DB)

4 NAC National antimicrobial susceptibility testing committee

5 Remit: NAC A NAC is a committee which deals with questions related to antimicrobial susceptibility testing at a national level. Membership: representatives of clinical microbiological diagnostic services national experts on susceptibility testing of bacteria (and fungi) representatives of reference clinical microbiology laboratories professional organisations/societies government representatives of other antibiotic committees Structure Chairperson, scientific secretary, educational officer and other 4 8 other representatives Funding national level or jointly by all laboratories

6 y r a r b i L e E C S r u t c e r L o e h t n i u l a n O by D I M

7 Tasks and objectives Strategy for AST on national level Implementation of breakpoints and methods Quality assurance on a national level Education of laboratory staff and clinical colleagues Liaison and consultation with EUCAST (EUCAST GC rep) Liaison with groups involved in AMR-surveillance (ECDC, EARSS,.).. Antimicrobial Policies NAC Antimicrobial Resistance Surveillance Antimicrobial Consumption and Policies

8 Implementation of EUCAST clinical breakpoints in Europe NABC (D, F, N, NL, S, UK) have implemented EUCAST breakpoints as they were developed Other countries are implementing EUCAST breakpoints With automated AST (Phoenix, Vitek2, MicroScan etc) With the development of the EUCAST disk diffusion test Countries outside Europe have started discussing whether or not to implement EUCAST breakpoints and methods

9 y r a r b i L e E C S r u t c e r L o e h t n i u l a n O by D I M

10 Implementation of the EUCAST disk diffusion AST The development of a EUCAST disk diffusion test started in Laboratories in many countries are involved (many dealing with pet bugs and pet drugs ) Questions and suggestions are funelled through the EUCAST Secretariat ESCMID has taken financial responsibility

11 y r a r b i L e E C S r u t c e r L o e h t n i u l a n O by D I M

12 EUCAST breakpoints and NACs EUCAST/NABC: France Germany Norway Sweden The Netherlands The UK NAC 2010/11: Austria Belgium Denmark Estonia Finland Hungary Ireland Italy Slovenia Spain Switzerland Discussion: Croatia Greece Israel Poland Russia Turkey Lithuania Latvia Portugal, Poland, Czeck republic, Slovakia, Serbia, Rumania

13 Implementation - Preparedness of AST manufacturers Information available on EUCAST website sultation/preparednessofmanufacturers_ pdf Preparedness of AST manufacturers (see next few slides)

14 Automated systems for AST Phoenix, BD - EUCAST breakpoints in Evaluations (3): EUCAST panels/cards - Several bugs and drugs are still missing Vitek2, BM - EUCAST breakpoints in 2010 but in need of major software update Cards containing mixture of breakpoints - Problems with concept EUCAST breakpoints - Evaluations ongoing - Several bugs and drugs are missing Microscan, Siemens - EUCAST breakpoints Launch April no known evaluation - Breakpoints panels and concept declared - Several bugs and drugs are missing

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21 EUCAST action on documentation Breakpoints QC limits Method description Slide presentation Reading guidance slideshow Implementation checklist usion_test Frequently asked questions (FAQs)

22 EUCAST action on education Teaching material on website Meetings Practical workshops Laboratory visits The laboratory in Växjö is an ESCMID Collaborative Centre the ESCMID Observership program can be used for visit. Publications

23 Implementation at local level Before routine use Ensure all stakeholders are informed of implications for their laboratory/hospital Appoint a champion to implement the method Visit laboratories using the method Plan well in advance media, disk, supplies templates, zone-reader setup computing (breakpoints/qc ranges) documentation Train staff in advance demonstrations, practical experience, ensure that QC requirements are met Use contacts in other laboratories and at EUCAST directly or through NACs or national EUCAST GC rep

24 Implementation at local level During introduction Ensure that adequate staffing is available will take more time at first Ensure that senior staff are available to answer questions and deal with problems Use national contacts National Antibiotic Committees Use contacts in laboratories already using the method Use EUCAST contacts Erika Matuschek Gunnar Kahlmeter Derek Brown Rafael Canton

25 Implementation at local level After implementation Keep the method up-to-date Use the EUCAST website regularly for the latest information and guidance Continue to educate staff Report problems to EUCAST Be prepared to help other laboratories

26 Implementation of EUCAST antimicrobial susceptibility testing methods Please send any comments and questions to