Development and validation of EUCAST Disk Diffusion breakpoints
The EUCAST Disk Diffusion test was developed by EUCAST under the auspices of ESCMID and with the help of many laboratories. The help of these laboratories is gratefully acknowledged. Most are listed under the EUCAST laboratory network. The work started in 2009 and is ongoing - new agents, new species, revsied or new breakpoints and new resistance mechanisms necessitates constant development and recalibration.
The files below list material and graphs used for determining zone diameter breakpoints to match MIC breakpoints (Example 1). The files are updated yearly.
Files January 2024:
- Enterobacterales
- Salmonella spp.
- Yersinia enterocolitica
- Plesiomonas shigelloides
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Stenotrophomonas maltophilia (see separate presentation of cefiderocol)
- Acinetobacter spp. (see separate presentation of cefiderocol)
- Staphylococcus aureus
- Staphylococcus, coagulase-negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp.
- Streptococcus pyogenes (group A)
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae - screen for beta-lactam resistance
- Viridans Group Streptococci
- Haemophilus influenzae
- Haemophilus influenzae - screen for betalactam resistance
- Moraxella catarrhalis
- Anaerobic bacteria (Bacteroides spp, Prevotella spp, Fusobacterium necrophorum, Clostridium perfringens, Cutibacterium acnes).
- Listeria monocytogenes
- Pasteurella spp.
- Campylobacter jejuni and C. coli
- Corynebacterium spp. (other than C.diphtheriae and C.ulcerans)
- Corynebacterium diphtheriae and C. ulcerans
- Aerococcus sanguinicola and A. urinae
- Kingella kingae
- Aeromonas spp.
- Achromobacter xylosoxidans
- Vibrio spp.
- Bacillus spp.
- Burkholderia pseudomallei
- Brucella melitensis - to be published during 2024
- Bacillus anthracis - to be published during 2024
Files February 2023:
- Enterobacterales
- Salmonella spp
- Yersinia enterocolitica
- Plesiomonas shigelloides
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Stenotrophomonas maltophilia (see separate presentation of cefiderocol)
- Acinetobacter spp. (see separate presentation of cefiderocol)
- Staphylococcus aureus
- Staphylococcus, coagulase-negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp.
- Streptococcus pyogenes (group A)
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae - screen for beta-lactam resistance
- Viridans Group Streptococci
- Haemophilus influenzae
- Haemophilus influenzae - screen for betalactam resistance
- Moraxella catarrhalis
- Anaerobic bacteria (Bacteroides spp, Prevotella spp, Fusobacterium necrophorum, Clostridium perfringens, Cutibacterium acnes).
- Listeria monocytogenes
- Pasteurella spp.
- Campylobacter jejuni and C. coli
- Corynebacterium spp. (other than C.diphtheriae and C.ulcerans)
- Corynebacterium diphtheriae and C. ulcerans
- Aerococcus sanguinicola and urinae
- Kingella kingae
- Aeromonas spp.
- Achromobacter xylosoxidans
- Vibrio spp.
- Bacillus spp.
- Burkholderia pseudomallei
Files from 2022:
- Enterobacterales (updated 28 February; temocillin included)
- Salmonella spp
- Yersinia enterocolitica
- Plesiomonas shigelloides
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Stenotrophomonas maltophilia (see below for cefiderocol)
- Acinetobacter spp. (see below for cefiderocol)
- Staphylococcus aureus
- Staphylococcus, coagulase-negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp.
- Streptococcus pyogenes (group A)
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae - screen for beta-lactam resistance
- Viridans Group Streptococci
- Haemophilus influenzae
- Haemophilus influenzae - screen for betalactam resistance
- Moraxella catarrhalis
- Anaerobic bacteria (Bacteroides spp, Prevotella spp, Fusobacterium necrophorum, Clostridium perfringens, Cutibacterium acnes)
- Listeria monocytogenes
- Pasteurella multocida
- Campylobacter jejuni and C.coli
- Corynebacterium spp.
- Aerococcus sanguinicola and urinae
- Kingella kingae
- Aeromonas spp.
- Achromobacter xylosoxidans
- Vibrio spp (available 2023)
- Bacillus spp.
- Burkholderia pseudomallei
- Cefiderocol – S. maltophilia and Acinetobacter (neither have clinical breakpoints but can be tested against PK/PD cutoffs)
Files from 2021 (previous presentations, related to older MIC breakpoints, are listed below the current)
Files from 2021 - Presentations related to MIC breakpoints in the EUCAST breakpoint Table 11. Graphs for Achromobacter xylosoxidans, Bacillus spp., Cefiderocol, Ceftolozane-tazobactam for H. influenzae, Imipenem-relebactam, Lefamulin were new. Others were reviewed and revised when necessary.
- Enterobacterales
- Salmonella spp
- Yersinia enterocolitica
- Plesiomonas shigelloides
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Stenotrophomonas maltophilia (see below for cefiderocol)
- Acinetobacter spp. (see below for cefiderocol)
- Staphylococcus aureus
- Staphylococcus, coagulase-negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp.
- Streptococcus pyogenes (group A)
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae - screen for beta-lactam resistance
- Viridans Group Streptococci
- Haemophilus influenzae
- Haemophilus influenzae - screen for betalactam resistance
- Moraxella catarrhalis
- Listeria monocytogenes
- Pasteurella multocida
- Campylobacter jejuni and C.coli
- Corynebacterium spp.
- Aerococcus sanguinicola and urinae
- Kingella kingae
- Aeromonas spp.
- Achromobacter xylosoxidans
- Bacillus spp.
- Burkholderia pseudomallei
- Cefiderocol – S. maltophilia and Acinetobacter (neither have clinical breakpoints but can be tested against PK/PD cutoffs).
Files from 2020 - Presentations related to MIC breakpoints in the EUCAST breakpoint Table 10.
- Enterobacterales
- Salmonella spp
- Yersinia enterocolitica
- Plesiomonas shigelloides
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Stenotrophomonas maltophilia
- Acinetobacter spp.
- Staphylococcus aureus
- Staphylococcus, coagulase-negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp.
- Streptococcus pyogenes (group A)
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae - screen for beta-lactam resistance
- Viridans Group Streptococci
- Haemophilus influenzae
- Haemophilus influenzae - screen for betalactam resistance
- Moraxella catarrhalis
- Listeria monocytogenes
- Pasteurella multocida
- Campylobacter jejuni and C.coli
- Corynebacterium spp.
- Aerococcus sanguinicola and urinae
- Kingella kingae
- Aeromonas spp.
- Burkholderia pseudomallei
Files from 2019 - Presentations related to MIC breakpoints in the EUCAST breakpoint Table 9.
- Enterobacterales
- Salmonella spp
- Yersinia enterocolitica
- Plesiomonas shigelloides
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Stenotrophomonas maltophilia
- Acinetobacter spp.
- Staphylococcus aureus
- Staphylococcus, coagulase-negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp.
- Streptococcus pyogenes (group A)
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae - screen for beta-lactam resistance
- Viridans Group Streptococci
- Haemophilus influenzae
- Haemophilus influenzae - screen for betalactam resistance
- Moraxella catarrhalis
- Listeria monocytogenes
- Pasteurella multocida
- Campylobacter jejuni and C.coli
- Corynebacterium spp.
- Aerococcus sanguinicola and urinae
- Kingella kingae
- Aeromonas spp.
Files from 2018 - Presentations related to MIC breakpoints in the EUCAST breakpoint Table 8.1.
- Enterobacteriaceae
- Salmonella spp
- Yersinia enterocolitica
- Plesiomonas shigelloides
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Stenotrophomonas maltophilia
- Acinetobacter spp.
- Staphylococcus aureus
- Staphylococcus, coagulase-negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp.
- Streptococcus pyogenes (group A)
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae - screen for beta-lactam resistance
- Viridans Group Streptococci
- Haemophilus influenzae
- Haemophilus influenzae - screen for betalactam resistance
- Moraxella catarrhalis
- Listeria monocytogenes
- Pasteurella multocida
- Campylobacter jejuni and C.coli
- Corynebacterium spp.
- Aerococcus sanguinicola and urinae
- Kingella kingae
- Aeromonas spp.
Files from 2017 - Presentations related to MIC breakpoints in the EUCAST breakpoint Table 7.0.
- Enterobacteriaceae
- Salmonella spp (pefloxacin)
- Pseudomonas aeruginosa
- Pseudomonas non-aeruginosa
- Acinetobacter spp
- Staphylococcus aureus
- Staphyococcus, Coagulase negative
- Staphylococcus saprophyticus
- Staphylococcus pseudintermedius
- Enterococcus spp
- Streptococcus pyogenes
- Streptococcus agalactiae
- Streptococcus pneumoniae
- Streptococcus pneumoniae and screen for betalactam resistance
- Streptococcus viridans
- Haemophilus influenzae
- Haemophilus influenzae and screen for betalactam resistance
- Moraxella catarrhalis
- Listeria monocytogenes
- Pasteurella multocida
- Campylobacter spp
- Corynebacterium spp
- Aerococcus sanguinicola and urinae
- Kingella kingae
Older versions can be obtained from the web master.
