Policy # MI_AST Page 1 of 159 Department of Microbiology Quality Manual Version: 5.15 CURRENT Section: Bacteriology Procedures Subject Title: Antimicrobial Susceptibility Manual Prepared by QA Committee Issued by: Laboratory Manager Revision Date: 9/21/2021 Approved by Laboratory Director: Next Review Date: 9/21/2023 Microbiologist-in-Chief Uncontrolled When Printed TABLE OF CONTENTS WHEN TO TEST ............................................................................................................................................. 6 Criteria for Susceptibility Testing ................................................................................................................ 6 WHAT TO TEST:............................................................................................................................................ 7 Enterobacterales ............................................................................................................................................... 7 E. coli O:157 .................................................................................................................................................... 8 Salmonella typhi .............................................................................................................................................. 8 Salmonella species other than S. typhi ............................................................................................................. 8 Shigella species................................................................................................................................................ 8 Vibrio species .................................................................................................................................................. 8 Acinetobacter species ...................................................................................................................................... 8 Pseudomonas aeruginosa ................................................................................................................................ 8 (8) Pseudomonas sp., Plesiomonas sp. and other afermenters ......................................................................... 9 Aeromonas species .......................................................................................................................................... 9 Stenotrophomonas maltophilia ........................................................................................................................ 9 Burkholderia cepacia Complex including [1]: ................................................................................................ 9 Haemophilus species ....................................................................................................................................... 9 Helicobacter pylori ........................................................................................................................................ 10 Moraxella catarrhalis .................................................................................................................................... 10 Neisseria gonorrhoeae .................................................................................................................................. 10 Neisseria meningitides ................................................................................................................................... 10 (9) Other fastidious Gram negatives (e.g. HACEK group, Pasteurella species) ............................................ 10 Campylobacter species .................................................................................................................................. 10 Staphylococcus aureus .................................................................................................................................. 10 Coagulase-negative Staphylococcus NOT Staphylococcus lugdunensis ....................................................... 11 Staphylococcus lugdunensis/ ......................................................................................................................... 12 Micrococcus species ...................................................................................................................................... 12 UNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY NOTE: This document is Uncontrolled When Printed. Any documents appearing in paper form that do not state "CONTROLLED COPY " in red print are not controlled and should be checked against the document (titled as above) on the server prior to use. Management System\UHN_Mount Sinai Hospital Microbiology\Standard Operating Procedures\Bacteriology Procedures\ Policy # MI_AST Page 2 of Department of Microbiology 159 Quality Manual Version: 5.15 CURRENT Section: Bacteriology Procedures Subject Title: Antimicrobial Susceptibility Manual Aerococcus species ........................................................................................................................................ 12 Enterococcus species ..................................................................................................................................... 12 Streptococcus pneumoniae ............................................................................................................................ 13 Group A, B, C, G Streptococcus ................................................................................................................... 13 Streptococcus bovis, viridans Streptococcus ................................................................................................. 13 Streptococcus anginosus group and small colony-ß-haemolytic Streptococcus ........................................... 13 Listeria species .............................................................................................................................................. 14 Corynebacterium species ............................................................................................................................... 14 Bacillus species.............................................................................................................................................. 14 Nocardia species............................................................................................................................................ 14 Anaerobes ...................................................................................................................................................... 14 Yeasts............................................................................................................................................................. 14 WHAT TO REPORT: .................................................................................................................................... 15 Urine – Gram Positive Susceptibility Reporting 1 – Staphylococcus species, MRSA ........................... 15 Urine – Gram Positive Susceptibility Reporting – 2 – Enterococcus species, Streptococcus species, Aerococcus species ....................................................................................................................................... 17 Urine - Gram Negative Susceptibility Reporting ...................................................................................... 19 Enterics ......................................................................................................................................................... 21 Respiratory and Miscellaneous Non-Sterile Sites - Gram Positive Susceptibility Reporting – 1 – Staphylococcus .............................................................................................................................................. 22 Respiratory and Miscellaneous Non-Sterile Sites - Gram Positive Susceptibility Reporting – 2 – Enterococcus, Streptococcus, Corynebacterium spp., Bacillus spp., viridans Streptococcus, Listeria spp., Aerococcus species ....................................................................................................................................... 24 Respiratory and Miscellaneous Non-Sterile Sites - Gram Negative Susceptibility Reporting – 1 – Enterobacterales, Acinetobater species, Pseudomonas aeruginosa, Aeromonas species ........................ 26 Respiratory and Miscellaneous Non-Sterile Sites - Gram Negative Susceptibility Reporting – 2 – Haemophilus species, M. catarrhalis, S. maltophilia, B. cepacia, Pseudomonas species (other than P. aeruginosa), fastidious gram-negative bacteria, non-fermenters, Neisseria meningitides, H. pylori. ... 28 Spinal Fluids – Gram Positive Susceptibility Reporting .......................................................................... 30 Spinal Fluids – Gram Negative Susceptibility Reporting – 1 – Enterobacterales and Acinetobacter spp., Salmonella species including S. typhi, Shigella species ............................................................................. 32 UNIVERSITY HEALTH NETWORK/MOUNT SINAI HOSPITAL, DEPARTMENT OF MICROBIOLOGY NOTE: This document is Uncontrolled When Printed. Any documents appearing in paper form that do not state "CONTROLLED COPY” in red print are not controlled and should be checked against the document (titled as above) on the server prior to use. Management System\UHN_Mount Sinai Hospital Microbiology\Standard Operating Procedures\Bacteriology Procedures\ Policy