What Is New in EUCAST?

What is new in EUCAST?

Christian G. Giske, MD/PhD Chair of EUCAST Chief consultant physician/Assoc. professor Karolinska Institutet and Karolinska University Hospital ESCMIDECCMID eLibrary 2018, Madrid © by author 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:ESCMID visiting members from eLibraryNACs (max one per meeting) © by author Implementation of EUCAST breakpoints, Jan 2018

ESCMID eLibrary © by author Implementation of EUCAST disk diffusion, Jan 2018

ESCMID eLibrary © by author 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 ESCMID eLibrary © by author ESCMIDUlm, eLibrary Germany 2016 © by author National AST Committees, Jan 2018

ESCMID eLibrary © by author NACs outside Europe

Countries with a NAC operating under EUCAST standards ESCMIDCountries with interest to establish aeLibrary NAC under EUCAST standards © by author 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 ESCMID eLibrary © by author Consultations 2018 Recently closed 1. Oral aminopenicillin breakpoints (H. influenzae and S. pneumoniae) 2. 3rd 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 ESCMID eLibrary © by author Breakpoint table v8.0

ESCMID eLibrary © by author Examples of changes

ESCMID eLibrary © by author MIC methodology and taxonomy

ESCMID eLibrary © by author Changes in ceftaroline breakpoints

ESCMID eLibrary © by author Macrolides and H. influenzae

ESCMID eLibrary © by author Breakpoints for Aeromonas

• Planned for release after ECCMID • Addition of oral breakpoints for amoxicillin and amoxicillin- clavulanic acid vs S. pneumoniae and H. influenzae • Corrected comments in Staphylococcus spp. (oxacillin) and Enterobacterales (carbapenems) tabs • Corrected dosing of colistin ESCMID eLibrary © by author 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 2018. (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. ESCMID eLibrary © by author Publications

• 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 • ESCMIDSeveral posters, e-posters and oraleLibrary presentations on AST and AFST © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author Thank you!