B - en - 2012/07 ETEST APPLICATION GUIDE - …

1 16273B - en - 2012 /07. ETEST APPLICATION GUIDE . AEROBES. RECOMMENDED. INOCULUM INCUBATION. SPECIFIC 6) 3) QUALITY CONTROL. ORGANISM MEDIA SUGGESTED MIC PANEL COMMENTS 4). PHENOTYPE. Suspension Temperature/ . McF equivalent Time (h) Strain ATCC. medium Atmosphere Staphylococcus 29213TM 4 mg/L. 35 2 C. MHA Saline Cefoxitin (FX) 18-24h aureus Ambient air S. aureus 43300TM > 4 mg/L. - Phenotype interpretation: MRSA. OX 4 g/mL and Mueller Hinton agar Saline Oxacillin (OX). 24h 35 2 C. S. aureus 43300TM XL 8 g/mL.

2 (MHA) + 2% NaCl Amoxicillin/clavulanic acid (XL) Ambient air - Heavier inoculum improves detection of low level R. - Phenotype interpretation: Oxacillin (OX) 35 2 C. BORSA MHA + 2% NaCl Saline 24h S. aureus 29213TM OX 4 g/mL and Amoxicillin/clavulanic acid (XL) Ambient air XL 4 g/mL. - Phenotype interpretation: OX g/mL. Mueller Hinton agar 35 2 C. MRCNS Saline Oxacillin (OX) 48h S. aureus 43300TM - Heavier inoculum (MHA) + 2% NaCl Ambient air improves detection of low Staphylococci level R. - mL inoculum/ 90mm plate - Phenotype interpretation: S.

3 Aureus VA 8 g/mL and 24h. VISA/hVISA 1) Brain Heart Infusion Vancomycin (VA) 35 2 C QC ranges: TP 8 g/mL, 2 BHI broth Confirm at 29213TM. (macromethod) agar (BHI) 1) Teicoplanin (TP) 1) Ambient air TP = g/mL OR. 48h VA = 1-4 g/mL TP 12 g/mL (alone). = VISA/hVISA. - Confirm VISA/hVISA by PAP. 18-24h. S. aureus 29213TM. ETEST GRD2) (Vancomycin (VA) / 35 2 C - Confirm VISA/hVISA by VISA/hVISA MHA + 5% blood BHI broth Confirm at S. aureus 700698TM. Teicoplanin (TP) 1)) Ambient air PAP. 48h S. aureus 700699TM.

4 - Phenotype interpretation: VISA/VRSA. 35 2 C TM VA 4 g/mL = VISA. (standard MHA Saline Vancomycin (VA) 24h S. aureus 29213. method). Ambient air VA 16 g/mL = VRSA. (CLSI). bioM rieux SA English - 1.. ETEST APPLICATION GUIDE 16273B - en - 2012 /07. RECOMMENDED. INOCULUM INCUBATION. SPECIFIC 6) 3) QUALITY CONTROL. ORGANISM MEDIA SUGGESTED MIC PANEL COMMENTS 4). PHENOTYPE. Suspension Temperature/ . McF equivalent Time (h) Strain ATCC. medium Atmosphere Clindamycin (CM). Daptomycin (DPC). MRSA Linezolid (LZ) 16-20h.

5 35 2 C. Secondary MHA Saline Vancomycin (VA) VA and TP S. aureus 29213TM. Ambient air panel Teicoplanin (TP) 1) full 24h Quinupristin/dalfopristin (QDA). Rifampicin (RI) 1). Staphylococci Benzylpenicillin (PG). Erythromycin (EM). Non-MRSA Linezolid (LZ) 16-20h. 35 2 C. secondary MHA Saline Trimethoprim/sulfamethoxazole (TS) VA and TP S. aureus 29213TM. Ambient air panel Vancomycin (VA) full 24h Teicoplanin (TP) 1). Ciprofloxacin (CI). Ampicillin (AM). Daptomycin (DPC). 16-20h. Linezolid (LZ). Confirm VA 35 2 C.

6 MHA Saline Quinupristin/dalfopristin (QDA) E. faecalis 29212TM. and TP at Ambient air Vancomycin (VA). 24h Teicoplanin (TP) 1). Minocycline (MC). Enterococci - Heavier inoculum preferable E. faecalis - SM > 1024 g/mL or 24h. QC ranges: GM > 512 g/mL =. Gentamicin (GM) high range 35 2 C. HLAR MHA Saline Confirm SM GM = 4-16 g/mL 29212TM positive HLAR (CLSI). Streptomycin (SM) high range 1) Ambient air at 48h SM = 64 256 g/mL - SM > 512 g/mL or GM > 128 g/mL =. positive HLAR. (EUCAST). Gentamicin (GM). Piperacillin/ tazobactam (PTc).

7 Cefepime (PM) 35 2 C Escherichia coli 25922TM. MHA (1 for mucoid Saline 16-20h Ciprofloxacin (CI) Ambient air E. coli 35218TM. organisms). Imipenem (IP) (PTc). Aztreonam (AT). Enterobacteriaceae Cefotaxime/cefotaxime + clavulanic E. coli 35218TM. acid (CT/CTL) Klebsiella 700603TM. Ceftazidime/ceftazidime + clavulanic 35 2 C pneumoniae - Investigate ND results by ESBL MHA (1 for mucoid Saline 16-20h acid (TZ/TZL) Ambient air (ESBL positive) an alternative method organisms). Cefepime/cefepime + clavulanic acid Pseudomonas 27853TM.

8 (PM/PML) 1) aeruginosa bioM rieux SA English - 2.. ETEST APPLICATION GUIDE 16273B - en - 2012 /07. RECOMMENDED. INOCULUM INCUBATION. SPECIFIC 6) 3) QUALITY CONTROL. ORGANISM MEDIA SUGGESTED MIC PANEL COMMENTS 4). PHENOTYPE. Suspension Temperature/ . McF equivalent Time (h) Strain ATCC. medium Atmosphere MBL MP/MPI Meropenem/Meropenem +EDTA 35 2 C K. pneumoniae 700603TM - Investigate ND results by 1) MHA (1 for mucoid Saline 16-20h. (MP/MPI) Ambient air K. pneumoniae BAA-2146TM an alternative method organisms).

9 Enterobacteriaceae Klebsiella 700603TM. pneumoniae Cefotetan/Cefotetan + Cloxacillin 35 2 C - Investigate ND results by AmpC 2) MHA Saline 16-20h (negative). (CN/CNI) Ambient air TM an alternative method K. pneumoniae BAA-1144. (positive). Ceftazidime (TZ). Gentamicin (GM). 16-20h. Aztreonam (AT) 35 2 C P. aeruginosa 27853TM. MHA (1 for mucoid Saline 48h for slow Ciprofloxacin (CI) Ambient air E. coli 35218TM. organisms) growers Imipenem (IP) (PTc). Pseudomonas spp. Piperacillin/tazobactam (PTc). P. aeruginosa 27853TM.

10 16-20h. 1) 35 2 C (negative) - Investigate ND results by MBL IP/IPI MHA (1 for mucoid Saline Imipenem/imipenem + EDTA (IP/IPI) 48h for slow Ambient air Stenotrophomonas 13636TM an alternative method organisms) growers maltophilia (positive). Ceftazidime (TZ). Meropenem (MP). 20-24h. Amikacin (AK) 35 2 C P. aeruginosa 27853TM. MHA (1 for mucoid Saline 48h for slow Ampicillin/sulbactam (AB) Ambient air E. coli 35218TM (AB). organisms) growers Levofloxacin (LE). Acinetobacter spp. Minocycline (MC). P. aeruginosa 27853TM.