by author What is new in EUCAST?

Transcription

1 What is new in EUCAST? Christian G. Giske, MD/PhD Chair of EUCAST Chief consultant physician/assoc. professor Karolinska Institutet and Karolinska University Hospital ECCMID 2018, Madrid

2 EUCAST SC 2018 Christian G. Giske, chair John Turnidge, scientific secretary Rafael Canton, clinical data coordinator Gunnar Kahlmeter, technical data coordinator/webmaster Sören Gatermann, Germany Christoffer Lindemann, Norway Johan Mouton, The Netherlands Alasdair MacGowan, UK Gerard Lina, France Arjana Tambic, Croatia Deniz Gur, Turkey Additionally: visiting members from NACs (max one per meeting)

3 Implementation of EUCAST breakpoints, Jan 2018

4 Implementation of EUCAST disk diffusion, Jan 2018

5 EUCAST Subcommittees STANDING Antifungal susceptibility testing Veterinary susceptibility testing Antimycobacterial Susceptibility testing AD HOC Intrinsic Resistance and Expert Rules MIC distributions and ECOFFs Joint working group with CLSI on disk mass development and QC criteria Detection of resistance mechanisms Polymyxins breakpoints and methods (joint with CLSI) Relationship between WGS (NGS) and phenotypic susceptibility testing Anaerobic AST

6 Ulm, Germany 2016

7 National AST Committees, Jan 2018

8 NACs outside Europe Countries with a NAC operating under EUCAST standards Countries with interest to establish a NAC under EUCAST standards

9 Recent general consultations 1. EUCAST guidelines for detection of resistance mechanisms 2. SOP for "MIC distributions and the determination of epidemiological cut-off values (ECOFFs) 3. Moraxella catarrhalis fluoroquinolone breakpoints 4. 2nd consultation on the definition of the Intermediate category. 5. Breakpoints for Aeromonas and Plesiomonas 6. Removal of macrolide breakpoints for Haemophilus influenzae

10 Recently closed Consultations Oral aminopenicillin breakpoints (H. influenzae and S. pneumoniae) 2. 3 rd consultation on definition of the Intermediate category Upcoming 1. Aminoglycoside breakpoints 2. Carbapenem breakpoints 3. Piperacillin-tazobactam breakpoints in H. influenzae 4. Temocillin 5. Tigecycline

11 Breakpoint table v8.0

12 Examples of changes

13 MIC methodology and taxonomy

14 Changes in ceftaroline breakpoints

15 Macrolides and H. influenzae

16 Breakpoints for Aeromonas

17 Reading example for Aeromonas

18 Clarifications regarding dosages

19 Breakpoint table v 8.1 Planned for release after ECCMID Addition of oral breakpoints for amoxicillin and amoxicillinclavulanic acid vs S. pneumoniae and H. influenzae Corrected comments in Staphylococcus spp. (oxacillin) and Enterobacterales (carbapenems) tabs Corrected dosing of colistin

20 The EUCAST Development Laboratory Developing EUCAST breakpoint table v 8.0 (published January 2018). Enterobacterales breakpoints validated for Plesiomonas shigelloides Breakpoints for Aeromonas spp. (Poster P0159) Colistin susceptibility testing evaluating commercially available methods for broth microdilution, agar dilution, gradient testing, disk diffusion. Publication in CMI. Several large validation field trials (multi-center studies). Rapid AST directly from blood culture bottles (eposters O0746 and O0746, Poster P1797). Disk diffusion methodology for rapidly growing anaerobes (Poster P0160 and P0161). Survey of the quality of antibiotic disks from nine manufacturers. To be submitted to CMI April (Poster P0156) Developing a substitute for fresh mechanically defibrinated horse blood in MH-F plates. (Poster P0154) Observerships for colleagues eager to learn about EUCAST methods and development.

21 Publications

22 EUCAST activities at ECCMID 2018 Educational workshop, Saturday 08:45-12:45 Meet the Experts EUCAST Frequently Asked Questions, Monday 07:45-08:45, Hall G How to get to ECOFFs for worldwide use as reference MIC, Tuesday 07:45-08:45, Hall J Open committee meetings EUCAST AFST general committee, Sunday 16:00-18:00, Hall M EUCAST General Committee, Monday 13:00-14:30, Hall M VetCAST General Committee, Monday 17:00-19:00, Hall M Symposium (SY037): Challenging breakpoints with supranormal dosing Several posters, e-posters and oral presentations on AST and AFST

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29 Thank you!