Panel Update 5 PDF

Adult Therapy
Guide Legend
Panel Update 5
International
9020-7493 Rev. B
SMN 10714735
Adult Therapy Guide Legend
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9020-7493, Rev. B
May 2013
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9020-7493B Page 2 of 158

Table of Contents
Revision Record ........................................................................................................................................................ 5
General Notes for Reporting Results: ..................................................................................................................... 6

DEFINITIONS: ............................................................................................................................................................. 6
INTERPRETIVE GUIDELINES ......................................................................................................................................... 6
®
SYNERGIES PLUS GRAM NEGATIVE PANELS: .............................................................................................................. 6
®
SYNERGIES PLUS GRAM POSITIVE PANELS: ............................................................................................................... 6
REFERENCED FROM THE CLSI M100-S22: ................................................................................................................. 6
MISCELLANEOUS NOTES: ........................................................................................................................................... 7
URINE/SYSTEMIC THERAPY INTERPRETATION RULES:.................................................................................................. 7
ADDITIONAL RULES:................................................................................................................................................... 7
Warning From the CLSI M100-S22: ......................................................................................................................... 7
Extreme Caution from the CLSI M100-S22: ........................................................................................................... 8
Use of Inducible Beta-Lactamase Flag:................................................................................................................... 8
Cefoxitin Screen: ....................................................................................................................................................... 9
Inducible Clindamycin: ............................................................................................................................................. 9
Streptococci Reporting (Viridans, Beta-hemolytic and S. pneumoniae): .......................................................... 10
Streptococci Limitations: ....................................................................................................................................... 10
Miscellaneous Fastidious Organism Limitation: .................................................................................................. 10
Miscellaneous Organism Recommendation: ........................................................................................................ 10
Synergies Screen Reporting: ................................................................................................................................. 10
Predicted Susceptibility Rules for Synergies plus Pos Panels: ......................................................................... 11
Extended Spectrum Beta-Lactamase (ESBL) Interpretations: ........................................................................... 12
ANTIMICROBIAL AGENT THERAPY GUIDE TABLES .......................................................................................... 15

DRIED OVERNIGHT AND RAPID (FLUOROGENIC) GRAM-NEGATIVE PANELS ............................................. 15
DRIED OVERNIGHT GRAM-POSITIVE PANELS ........................................................................... ………………64
®
SYNERGIES PLUS GRAM-NEGATIVE PANELS .............................................................................................. 112
®
SYNERGIES PLUS GRAM-POSITIVE PANELS ................................................................................................ 126
FASTIDIOUS PANELS - STREPTOCOCCI ......................................................................................................... 130
FASTIDIOUS PANELS - HAEMOPHILUS ........................................................................................................... 145
Species Classifications for Organism Groups ................................................................................................... 153
ACINETOBACTER GROUP ................................................................................................................................ 153
ENTEROBACTER GROUP ................................................................................................................................. 153
CITROBACTER GROUP ..................................................................................................................................... 153
CITROBACTER FREUNDII GROUP ................................................................................................................... 153
ESBL GROUP- SCREENING .............................................................................................................................. 153
ESBL GROUP- CONFIRMATION ........................................................................................................................ 153
CITROBACTER AMALONATICUS/KOSERI GROUP ......................................................................................... 153
PROTEUS/PROVIDENCIA GROUP .................................................................................................................... 153
KLEBSIELLA GROUP .......................................................................................................................................... 153
PROVIDENCIA GROUP ...................................................................................................................................... 154
SALMONELLA/SHIGELLA GROUP .................................................................................................................... 154
SERRATIA GROUP ............................................................................................................................................. 154
9020-7493B Page 3 of 158

SHIGELLA GROUP.............................................................................................................................................. 154
VIBRIO SPP other than V. cholerae ..................................................................................................................... 154
MISCELLANEOUS FASTIDIOUS GROUP-NEG ................................................................................................. 154
MISCELLANEOUS FASTIDIOUS GROUP-POS ................................................................................................. 154
PROTEUS GROUP .............................................................................................................................................. 154
AEROMONAS SPP. GROUP ……………………………………………………………………………………….. .... 154
OTHER SPECIES GROUP .................................................................................................................................. 155
VIRIDANS STREPTOCOCCI GROUP................................................................................................................. 156
MISCELLANEOUS STREPTOCOCCI GROUP ................................................................................................... 156
BETA-HEMOLYTIC STREPTOCOCCUS GROUP .............................................................................................. 156
GROUP A STREPTOCOCCUS GROUP ............................................................................................................. 156
ENTEROCOCCUS GROUP (for DRIED-OVERNIGHT GRAM-POSITIVE PANELS) ......................................... 156
®
ENTEROCOCCUS GROUP (for SYNERGIES PLUS GRAM-POSITIVE PANELS)........................................... 156
COAGULASE NEGATIVE STAPHYLOCOCCI GROUP ..................................................................................... 157
Specific Classifications for Panel Groups .......................................................................................................... 158
9020-7493B Page 4 of 158

Revision Record
Rev. Date Affected Sections
A March Initial revision.
2013
B May Add NC54 panel to Note 2 of Fosfomycin Table with 16, 32 and 64 dilutions in the Dried Overnight and
2013 Rapid (Fluorogenic) Gram-Negative Panels section
9020-7493B Page 5 of 158

General Notes for Reporting Results:
Definitions:
• Minimum inhibitory concentration (MIC) dilutions are a sequence of 3 or more dilutions.
• Breakpoint dilutions are a 1 or 2 dilution sequence.
• For therapy reporting, Enterobacteriaceae includes all fermenters (except V. cholerae and Y. pestis) in the
LabPro Information Manager database unless otherwise noted.
• For therapy reporting, Non-Enterobacteriaceae includes all non-fermenters unless otherwise noted.
• For therapy reporting, EUCAST and CLSI reports for Haemophilus influenzae and Haemophilus
parainfluenzae.
INTERPRETIVE GUIDELINES
The Interpretive Guidelines were based on the following references, unless otherwise noted.
Reference Revision
EUCAST Clinical Breakpoint Tables 2013-02-11 (Version 3.1)
2013-01-01 (Version 3.0)
2012-01-01 (Version 2.0)
January 2011 (version 1.3)
December 2009 (Version 1.0)
CLSI M45-A2; Methods for Antimicrobial August 2010
Dilution and Disk Susceptibility Testing of
Infrequently Isolated or Fastidious Bacteria,
nd
2 edition
CLSI M100-S9, S14, S17, S19, S21 and S22; January 1999, 2004, 2007, 2009,
Performance Standards for Antimicrobial 2011 and 2012
Susceptibility Testing; Informational
Supplements
ANVISA Guidelines Nota Technica No. 1/2010 (2010-10-
25)
SFM January 2008, 2009 and 2012
MENSURA An Clin 2001; 26 (4) 109-126
Synergies plus® Gram Negative panels:

®
• The Synergies plus Gram Negative panels contain antimicrobial agents that will report-when-ready together
with dried overnight antimicrobial agents.
• The report-when-ready antimicrobial agents may report rapid results (4.5 - 12 hrs) or overnight results (16 - 20
hrs) and the dried overnight antimicrobial agents will report overnight results (16 - 20 hrs).
• The report-when-ready antimicrobial agents can only be read rapidly (4.5 - 12 hrs) by the WalkAway SI or
WalkAway plus System. Manual reading of all antimicrobial agents must be performed at 16 – 20 hrs.
Synergies plus® Gram Positive panels:

®
• The Synergies plus Gram Positive panels contain antimicrobial agents that will report-when-ready.
• The report-when-ready antimicrobial agents may report rapid results (4.5 - 12 hrs) or overnight results (16 - 18 hrs).
• The report-when-ready antimicrobial agents can only be read rapidly (4.5 - 12 hrs) by the WalkAway SI or
WalkAway plus System. Manual reading of all antimicrobial agents must be performed at 16 - 20 hrs.
• For all Beta-lactam antimicrobial agents, the predicted interpretation for staphylococci will be based on the
penicillin and/or Oxacillin MICs.
• MICs will only be reported for staphylococci and/or enterococci. MICs will not be reported for streptococci.
Referenced from the CLSI M100-S22

“For some organism groups excluded from Tables 2A through 2J, the CLSI guideline M45 Methods for
Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria provides
suggestions for standardized methods for susceptibility testing, including information about drug selection,
interpretation and QC. The organism groups covered in that document are Abiotrophia and Granulicatella spp.
(formerly known as nutritionally deficient or nutritionally variant streptococci); Aeromonas spp.; Bacillus spp.
(not B. anthracis), Campylobacter jejuni/coli, Corynebacterium spp. (including C. diptheriae); Erysipelothrix
rhusiopathiae, the HACEK group: Aggregatibacter spp. (formerly Haemophilus aphrophilus, H. paraphrophilus,
9020-7493B Page 6 of 158

H. segnis and Actinobacillus actinomycetemcomitans), Cardiobacterium spp., Eikenella corrodens, and
Kingella spp.; Helicobacter pylori; Lactobacillus spp.; Leuconostoc spp.; Listeria monocytogenes; Moraxella
catarrhalis; Pasteurella spp.; Pediococcus spp.; potential agents of bioterrorism; and Vibrio spp., including V.
cholerae.
For organisms other than those in the groups mentioned above, studies are not yet adequate to develop
reproducible, definitive standards to interpret results. These organisms may require different media or different
atmospheres of incubation, or they may show marked strain-to-strain variation in growth rate. For these
microorganisms, consultation with an infectious disease specialist is recommended for guidance in determining
the need for susceptibility testing and in the interpretation of results. Published reports in the medical literature
and current consensus recommendations for therapy of uncommon microorganisms may obviate the need for
testing. If necessary, a dilution method usually is the most appropriate testing method, and this may require
submitting the organism to a reference laboratory. Physicians should be informed of the limitations of results
and advised to interpret results with caution.”
Miscellaneous Notes:
S = Susceptible Blac = Beta-lactamase positive
I = Intermediate TFG = Thymidine dependent strain
R = Resistant Blank = Data not available, or drug not advisable or tested
R* = Extrapolated Resistance N/R = Not reported
S* = Extrapolated susceptible result NS = Nonsusceptible
• MIC values are reported in µg/ml or mg/l.

• If the MIC was not reported, “N/R” will be printed in the MIC area.
• If a column under an organism group is blank, interpretations are not available.
• The following antimicrobial agents can be reported for V. cholerae with CLSI interpretations: Ampicillin,
Chloramphenicol, Tetracycline and Trimethoprim/Sulfamethoxazole.
Urine/Systemic Therapy Interpretation Rules:

1. For all panels (dried overnight, rapid fluorogenic; Gram-positive or Gram-negative) therapy interpretation will be
driven by source of specimen.
2. In the LabPro System, if the specimen source is systemic (non-urine), only the systemic therapy will be reported,
when available.
3. In the LabPro System, if the specimen source is urine, only urine therapies will be reported, when available.
Additional Rules:
1. If a Haemophilus or Neisseria from the HNID database is stored as the organism for a non-HNID panel, the
therapies will not be printed.
2. If a panel has not been tested, or the panel has not been interpreted, the phrase “results to follow” will be
printed in the therapy area.
3. Additional antimicrobial agent MIC results will print after the panel MIC results.
4. Therapy results for one isolate may require two or more successive pages.
5. Only results of testing with penicillin, vancomycin, cefotaxime, ceftriaxone or meropenem should be reported
routinely for CSF isolates of S. pneumoniae.
6. For Y. pestis, studies have demonstrated that although beta-lactam antimicrobial agents may appear active in
vitro they lack efficacy in animal models of infection. These antimicrobial agents should not be reported as
susceptible.
Warning from the CLSI M100-S22:

The following antimicrobial agents should not be routinely reported for bacteria isolated from the CSF that are
included in this document. These antimicrobial agents are not the drugs of choice and may not be effective for
treating CSF infections caused by these organisms (ie, the bacteria included in Tables 2A through 2J):
agents administered by oral route only

st nd
1 - and 2 -generation cephalosporins (except cefuroxime parenteral)
and cephamycins
clindamycin
macrolides
tetracyclines
fluoroquinolones
9020-7493B Page 7 of 158
Extreme Caution from the CLSI M45-A2:
Public health officials should be notified about all isolates presumptively identified as B. anthracis, Brucella spp., Y.
pestis, B. mallei, B. pseudomallei or F. tularensis. Confirmation of isolates of these bacteria may require
specialized testing only available in reference or public health laboratories.
Use of Inducible Beta-Lactamase Flag:
There is an option to utilize a flag to note possible inducible beta-lactamase isolates on the Long Format Patient
Report. If customization is to be used, the therapies for the organisms and antimicrobial agents listed below will
NOT utilize the attached pages of this document. The flag will perform as follows:
Possible inducible beta-lactamase producing organisms:

Aeromonas caviae Citrobacter braakii/freundii/sedlakii
Aeromonas hydrophila Citrobacter werkmanii/youngae
Aeromonas hydrophila group Enterobacter aerogenes
Aeromonas hydrophila/trota/veronii Enterobacter cloacae
Aeromonas jandaei Hafnia alvei
Aeromonas schubertii Morganella morganii
Aeromonas species Providencia alcalifaciens
Aeromonas sobria Providencia alcalifaciens/rustigianii
Aeromonas trota Providencia rettgeri
Aeromonas veronii Providencia rustigianii
Citrobacter braakii Providencia stuartii
Citrobacter freundii complex Pseudomonas aeruginosa
Citrobacter sedlakii Serratia liquefaciens
Citrobacter werkmanii Serratia marcescens
Citrobacter youngae
Beta-lactam antimicrobial agents for inducible beta-lactamase flag:

Amoxicillin Cefotetan
Amoxicillin/K Clavulanate Cefoxitin
Ampicillin Cefpodoxime
Ampicillin/Sulbactam Cefsulodin
Azlocillin Ceftazidime
Aztreonam Ceftizoxime
Carbenicillin Ceftriaxone
Cefaclor Cefuroxime
Cefamandole Cephalothin
Cefazolin Loracarbef
Cefdinir Mecillinam
Cefixime Mezlocillin
Cefmetazole Piperacillin
Cefonicid Piperacillin/Tazobactam
Cefoperazone Ticarcillin
Cefoperazone/Sulbactam Ticarcillin/K Clavulanate
Cefotaxime
If the inducible beta-lactamase flag is customized, an “IB” flag will appear on the Long Format Patient Report
for all the above listed organism-drug combinations in place of the Susceptible (S) therapy result.
9020-7493B Page 8 of 158

Cefoxitin Screen
The Dried Cefoxitin Screen is intended to determine the susceptibility of staphylococci to the penicillinase-
stable beta-lactams, using the Cefoxitin Screen Well (CfxS) and the Oxacillin MIC result at 16/18 hours. The
CfxS result and Oxacillin MIC are read independently at 16/18 hours and then processed through the LabPro
software or interpreted manually to determine the final interpretation to the penicillinase-stable beta-lactams
(i.e., Oxacillin). The interpretation rules are shown in the following table:
Oxacillin Interpretation
S. aureus or S. lugdunensis
CfxS Oxacillin MIC Other CNS
≤ 0.25 S S
0.5 S S*
≤ 4 Neg R Check mecA
1 or 2 S
(see comment)
>2 R R
≤ 0.25 R* R*
0.5 R* R
> 4 Pos
1 or 2 R* R
>2 R R
Comment: CNS with CfxS ≤ 4 and Oxacillin MICs of 1 or 2 give variable mecA results. Perform mecA testing
if beta-lactam therapy is critical for patient care.
Interpretations of S* or R* are used by the LabPro software when the Cefoxitin Screen result changes the
interpretation of the Oxacillin MIC result. The LabPro software will flag CNS isolates when CfxS is negative
and Oxacillin MICs are 1 or 2 µg/ml. The default interpretation will be R, however, mecA status is variable and
must be checked before these isolates are reported as Oxacillin susceptible (mecA negative only). These
criteria should also be followed when interpreting the results manually; however, the asterisk is not required.
For panels containing Oxacillin only: Staphylococci should be reported as resistant to Ampicillin, Amoxicillin/K
Clavulanate, Ampicillin/Sulbactam, Ertapenem, Imipenem, Meropenem, Penicillin, Piperacillin/Tazobactam,
Ticarcillin/K Clavulanate and the Cephalosporin antimicrobics (regardless of the MIC) when Oxacillin MICs are
>2 μg/ml for S. aureus and S. lugdunensis and ≥0.5 μg/ml for coagulase negative staphylococci other than S.
lugdunensis.
For panels containing both Oxacillin and the Cefoxitin Screen Well (CfxS): Staphylococci should be reported as
resistant to Ampicillin, Amoxicillin/K Clavulanate, Ampicillin/Sulbactam, Ertapenem, Imipenem, Meropenem,
Penicillin, Piperacillin/Tazobactam, Ticarcillin/K Clavulanate and the Cephalosporin antimicrobics (regardless of
the MIC) when CfxS is > 4 μg/ml for all staphylococci or Oxacillin MICs are >2 μg/ml for S. aureus and S.
lugdunensis or > 0.5 μg/ml for other coagulase negative staphylococci. Based on MicroScan clinical studies, for
coagulase negative staphylococci other than S. lugdunensis when CfxS is ≤ 4 μg/ml and Oxacillin MIC is 0.5,
the mecA status has been shown to be negative and the Oxacillin interpretation will be reported as S*. For
coagulase negative staphylococci other than S. lugdunensis when CfxS is ≤ 4 μg/ml and Oxacillin MIC is 1 or 2,
mecA status is variable and must be checked before reporting these antimicrobial agents as susceptible.
Inducible Clindamycin
The Inducible Clindamycin test (ICd) is intended to detect inducible clindamycin resistance in staphylococci
intermediate or resistant to erythromycin and susceptible or intermediate to clindamycin. Expression of
resistance due to the erm gene may require induction by erythromycin. Results of ICd are equivalent to the D-
zone disk approximation test. Reported for systemic sources only.
Tests Negative Positive

Inducible Clindamycin Test ≤ 4/0.5 > 4/0.5
- Staphylococci
When ICd is reported as Positive (>4/0.5) the clindamycin result will be reported as resistant (R*)
regardless of the MIC.
9020-7493B Page 9 of 158

Streptococci Reporting (Viridans, Beta-hemolytic and S. pneumoniae):
®
1. MICroSTREP plus panels can report antimicrobial agent results for all streptococci: S. pneumoniae, beta-
hemolytic streptococci, viridans streptococci and viridans streptococci (S. bovis group).
2. The Dried Overnight Gram-Positive panels can report antimicrobial agent results for beta-hemolytic
streptococci (S. agalactiae) and viridans streptococci (S. bovis) only.
3. Antimicrobial agent results for viridans streptococci (S. bovis) will be reported using viridans streptococci
breakpoints (CLSI and EUCAST).
4. Antimicrobial agent results for beta-hemolytic streptococci (S. agalactiae) will be reported using beta-hemolytic
streptococci breakpoints (CLSI) or Streptococcus groups A, B, C and G breakpoints (EUCAST).
5. Antimicrobial agent results for viridans streptococci (S. bovis) and beta-hemolytic streptococci (S.
agalactiae) will be reported using other streptococci breakpoints when using SFM interpretive guidelines.
Streptococci Limitations:
®
1. S. pneumoniae is contraindicated for use on the Antimicrobial Susceptibility Test (AST) portion of MicroScan
Dried Overnight Gram positive panels.
2. All streptococci, except beta-hemolytic streptococci (S. agalactiae) and viridans streptococci (S. bovis) are
®
contraindicated on MicroScan Dried Overnight Gram positive panels.
®
3. All streptococci are contraindicated on Synergies plus Positive panels.
Miscellaneous Fastidious Organism Limitation:

1. MICs for Actinobacillus actinomycetemcomitans, Bordetella pertussis, Bordetella parapertussis, CDC groups
EO-2, HB-5, EF-4A and EF-4B, Eikenella corrodens, Kingella species, Moraxella atlantae, Moraxella lacunata,
Moraxella non-liquifaciens, Moraxella osloensis, Moraxella species/Psychrobacter species, Psychrobacter (M.)
phenylpyruvicus, Oligella urethralis, Oligella ureolytica, Pasteurella species, Mannheimia (P.) haemolytica,
Myroides species, Roseomonas species, Neisseria elongata and Neisseria weaveri are contraindicated for use
and should not be reported on MicroScan® Dried Overnight panels, and Rapid (fluorogenic)/Synergies plus®
panels. An ID may be obtained on the Rapid (fluorogenic) panel. An ID may be obtained on the rapid
(fluorogenic)/Synergies plus® panels with the exception of Bordetella pertussis and Bordetella parapertussis.
Refer to back of therapy guide (Miscellaneous Fastidious Organism Group).
2. MICs for Abiotrophia/Granulicatella species, Aerococcus urinae, Aerococcus viridans, Erysipelothrix species,
Gemella haemolysans, Gemella morbillorum, Gemella species, Kytococcus sedentarius, Leuconostoc
species, Listeria innocua/seeligeri, Pediococcus species, Rhodococcus equi, Rothia dentocariosa, Rothia
mucilaginosa, and Rothia species are contraindicated for use and should not be reported on MicroScan Dried
Overnight Gram positive panels, and Synergies plus Positive panels. An ID may be obtained on the Synergies
plus Positive panels. Refer to the back of this therapy guide (Miscellaneous Fastidious Organism Group-Pos).
Miscellaneous Organism Recommendation:

®
For the Synergies plus Gram-Negative Panels, sufficient strains of Vibrio cholerae were not tested to establish
efficacy with Ampicillin, Chloramphenicol, Tetracycline and Trimethoprim/Sulfamethoxazole. Interpretive
breakpoints should not be reported.
Synergy Screen Reporting
Gentamicin Synergy Screen Streptomycin Synergy Kanamycin Synergy

(GmS) Reporting
1
Screen Screen
(StS) (KSS )
1 2
Reporting Reporting
Enterococci ≤500 = S, >500 = R ≤1000 = S, >1000 = R ≤1000 = S, >1000 = R
Streptococci Do not report, drug, therapy Do not report, drug, therapy ≤1000 = S, >1000 = R
(S. agalactiae and or MIC. or MIC.
S. bovis group)
1
Based on CLSI M100-S22.
2
Based on French Market Center request in 1995.
9020-7493B Page 10 of 158

Predicted Susceptibility Rules for Synergies plus Pos Panels
The predicted susceptibility results for staphylococci are based on the interpretive results for penicillin and/or
Oxacillin.
The following antimicrobial agents may have a predicted susceptibility result for the Synergies plus Pos panels.
Antimicrobial Antimicrobial Antimicrobial Agent If If If Penicillin-S or R

Class Subclass Penicillin–S & Penicillin-R & & Oxacillin-R
Oxacillin-S Oxacillin-S
Penicillins Aminopenicillin Amoxicillin S* R* R*
Ampicillin S* R* R*
Ureidopenicillin Piperacillin S* R* R*
Carboxypenicillin Ticarcillin S* R* R*
β-lactam/ β- Amoxicillin-clavulanate S* S* R*
lactamase (Aug)
inhibitor Ampicillin-sulbactam S* S* R*
combinations Piperacillin-tazobactam S* S* R*
Ticarcillin-clavulanate S* S* R*
(Tim)
Cephems Cefaclor S* S* R*
Cefazolin S* S* R*
Cefdinir S* S* R*
Cefepime S* S* R*
Cefotaxime S* S* R*
Cefpodoxime S* S* R*
Ceftriaxone S* S* R*
Cefuroxime S* S* R*
Cephalothin S* S* R*
Carbapenems Ertapenem S* S* R*
Imipenem S* S* R*
Meropenem S* S* R*
An asterisk (*) will appear beside every predicted interpretation
9020-7493B Page 11 of 158

Extended Spectrum Beta-Lactamase (ESBL) Interpretations:
The software has two different sets of rules for Screen and confirmation testing for ESBL-producing organisms on
®
Dried Overnight Gram-Negative Panels and Synergies plus Gram-Negative Panels. The SCREEN for suspected
ESBL-producing organisms is for Escherichia coli, K. oxytoca, and K. pneumoniae only and utilizes cefpodoxime (1
or 4 µg/ml, depending on panel type), aztreonam, cefotaxime, ceftazidime, ceftriaxone, ESBL-a (cefpodoxime at 1
or 4 µg/ml depending on panel type) and ESBL-b (ceftazidime, 1 µg/ml) as Screening agents. P. mirabilis utilizes
cefotaxime, ceftazidime and cefpodoxime (1 µg/ml) as screening agents. Some antimicrobials used as screening
®
agents on the Dried Gram-Negative Panels are also present on the Synergies plus panels; however, only ESBL-a
®
and ESBL-b are used as screening agents for Synergies plus panels.
ESBL CONFIRMATION testing utilizes a comparison of MIC values obtained with ceftazidime to ceftazidime/ K.
clavulanate (4 µg/ml), or cefotaxime to cefotaxime/ K. clavulanate (4 µg/ml). Some older panels compare
ceftazidime to the BSE well (ceftazidime/ K. clavulanate (2 µg/ml)). The MIC to the single antimicrobial must be ≥3
doubling dilutions greater than the MIC to the combination antimicrobial. If either comparison meets the criteria for
a positive result, the confirmation test will be positive. ESBL confirmation rules take precedence over ESBL
Screening rules in the software. ESBL confirmation rules apply to the following members of the
Enterobacteriaceae: Citrobacter amalonaticus, C. koseri (diversus), C. farmeri, C. freundii complex, Citrobacter
species, Enterobacter aerogenes, E. cloacae, Escherichia coli, K. oxytoca, K. pneumoniae, Morganella morganii,
Proteus mirabilis, P. vulgaris, P. rettgeri, Salmonella species, and Serratia marcescens. The ESBL confirmation
test is being applied to more organisms than are included in the CLSI ESBL confirmation test and should not be
construed as being CLSI approved.
If the ESBL Screen is activated, the report generated for a suspected ESBL-producing strain of E. coli, K.
pneumoniae, K. oxytoca or P. mirabilis will report MIC values with normal SIR interpretations for all antimicrobial
agents tested. However, if elevated MIC values are obtained for one or more of the screening antimicrobial
agents, those agents giving the elevated MIC values will carry the interpretation “EBL?”
The report generated for a CONFIRMED ESBL-producing strain will still report MIC values for all antimicrobial
agents tested; however, the single or screening antimicrobial agents, including ESBL-a or ESBL-b, giving elevated
MIC values will carry the interpretation “ESBL”, while all other cephalosporins, penicillins and aztreonam will have
MIC values but will be given the interpretation R*.
The footnotes on the patient report corresponding to these interpretations are as follows:
• “EBL?” indicates that a particular strain is a suspected ESBL. Confirmatory tests are needed to differentiate
ESBLs from other beta-lactamases.
• “ESBL” indicates that a particular strain is a confirmed ESBL.
• R* indicates resistance to cephalosporins, penicillins and aztreonam is due to confirmed extended-spectrum
beta-lactamases (ESBL).
These special interpretations will not appear if the laboratory chooses “no” when a suspected or confirmed ESBL-
producer is flagged; normal SIR interpretative categories will be reported.
9020-7493B Page 12 of 158

Interpretations Reported as “ESBL?” or “ESBL” for the following ESBL Screening Antimicrobial Agents:
Drug Panel Dilution Ranges MIC
Cefpodoxime 0.5-1 >1
CPD1,3 1 >1
1-4 >4
Aztreonam 1-4, 32 >2
AZT 1-16 >2
1, 4-8 >4
1, 4-16 >4
1, 8-16 >8
1,8 >8
2-16 >4
4-16 >8
4-32 >8
8-16 >16
Cefotaxime 0.5-2,16 >2
CFT 1-16 >2
1-32 >2
1-64 >2
1-2, 16 >2
1-2, 8-16 >2
1-2, 8-32 >2
2-32 >4
2-8, 32 >4
2, 8-32 ≥8
2, 16 >16
4-32 >8
4-8, 32 >8
8-32 >16
8,32 >32
Ceftazidime 0.5-8 >2
CAZ 1-8 >2
1-16 >2
1-32 >2
1, 4-8 >4
1, 4-16 >4
1, 8-16 >8
1, 8 >8
1-128 >2
2-16 >4
4-32 >8
8-16 >16
Ceftriaxone 0.5-2 >2
CAX 1-8 >2
1-2, 8, 32 >2
2-32 >4
4-32 >8
4-8, 32 ≥8
8-32 >16
8,32 >32
ESBL-a1,3 4 >4
(Cefpodoxime)
ESBL-b,3 1 >1
(Ceftazidime)
1. Panels containing a dilution of 4 µg/ml Cefpodoxime will follow ESBL rules based on current CLSI
documents. Panels with dilutions of 1 µg/ml or 1-2 µg/ml Cefpodoxime will follow CLSI/NCCLS M100-S9.
®
2. Rapid results (<16 hrs) are not provided for ESBL-a and ESBL-b on Synergies plus Gram-Negative
panels. Results are available at 16-20 hours.
3. P. mirabilis utilizes Cefotaxime, Cefpodoxime at > 1 µg/ml and Ceftazidime as screening agents.
9020-7493B Page 13 of 158

Interpretations Reported as R* for the following Antimicrobial Agents:
When a confirmed ESBL is selected, the MIC interpretations for all other cephalosporins and penicillins report
as R* - Predicted resistance due to extended-spectrum beta-lactamase (ESBL).
Cephalosporins Penicillins
Cefazolin CFZ Cefuroxime CRM Amoxicillin AMX
Cefepime CPE Cephalothin CF Ampicillin AM
Cefoperazone CFP Ceftizoxime CZ Mecillinam MEC
Cefaclor CFR Ceftriaxone CAX Mezlocillin MZ
Cefdinir CDN Piperacillin PI
Cefixime CFE Ticarcillin TI
Interpretations Reported as S, I or R for the following Antimicrobial Agents:

When a confirmed ESBL is selected, MIC interpretations for the following antimicrobial agents report as S, I or
R. The normal rules for interpreting the MICs for these antimicrobial agents do not change.
Beta-Lactam/
Beta-Lactamase Inhibitors Carbapenems Cephamycins
Amoxicillin-K Clavulanate AUG Imipenem IMP Cefotetan CTN
Ampicillin-Sulbactam A/S Meropenem MER Cefoxitin CFX
Cefoperazone-Sulbactam C/S Ertapenem ETP
Piperacillin-Tazobactam P/T Doripenem DOR
Ticarcillin-K. Clavulanate TIM
9020-7493B Page 14 of 158

ANTIMICROBIAL AGENT THERAPY GUIDE TABLES
DRIED OVERNIGHT AND RAPID (FLUOROGENIC) GRAM-NEGATIVE PANELS
Amikacin MIC ENTEROBACTERIACEAE NON- ACINETOBACTER SPP. PSEUDOMONAS

ENTEROBACTERIACEAE SPP.
(Ak)
> R R R R
32 R I R R
16 I S I I
8 S S S S
4 S S S S
2 S S S S
NOTE: 1. Enterobacteriaceae, Acinetobacter spp. and Pseudomonas spp. therapies based on EUCAST V3.1.
2. Non-Enterobacteriaceae (except for Acinetobacter spp. and Pseudomonas spp.) therapy based on CLSI
M100-S22.
3. Use for EUCAST Blended panel class, except for NBC45, NBC46, NBC49E, NM40, NUC56 and NUC69E
panels.
4. For Dried Overnight panels, do not report therapy for Salmonella/Shigella group because dangerously
misleading results can occur.
5. Do not report therapy for B. cepacia, B. pseudomallei, S. maltophilia and Y. pestis.
Amikacin MIC ENTEROBACTERIACEAE NON- ACINETOBACTER SPP. PSEUDOMONAS

(Ak)
> R R R R
16 I S I I
8 S S S S
2. Non-Enterobacteriaceae (except for Acinetobacter spp. and Pseudomonas spp.) therapy based on
CLSI M100-S22.
3. Use for NBC45, NBC46, NM40, NUC56 and NUC69E panels.
6. Based on CLSI M100-S22 interpretive guidelines for Non-Enterobacteriaceae, all MICs of >16 will report
as R, since these dilutions do not differentiate between I and R (S≤16, I=32, R≥64).
Amikacin (Ak) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R R R
32 R R R
16 I I I
8 S S S
4 S S S
2 S S S
NOTE: 1. Therapy based on EUCAST V3.1.
2. Use for EUCAST panel class.
4. Do not report therapy for Y. pestis.
9020-7493B Page 15 of 158

Amikacin (Ak) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
32 I I I
16 S S S
8 S S S
4 S S S
2 S S S
NOTE: 1. Therapy based on CLSI M100-S22.
> R R R
16 S S S
8 S S S
2. Use for NUC69C panel
4. Do not report therapy for B. cepacia, B. pseudomallei, S. maltophilia and Y. pestis. .
5. Based on CLSI M100-S22 interpretive guidelines for Enterobacteriaceae, Non-Enterobacteriaceae and
P. aeruginosa, all MICs of >16 will report as R, since these dilutions do not differentiate between I and R
(S≤16, I=32, R≥64).
Amoxicillin (Amx) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. .

> R
8 S
4 S
2 S
1 S
3. Do not report therapy for Y. pestis because dangerously misleading results can occur.
4. Do not report therapy for Aeromonas spp., Plesiomonas shigelloides and Vibrio spp.
Amoxicillin / MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.

K Clavulanate (Aug)
> R
16/8 R
8/4 S
4/2 S
2/1 S
2. Use for EUCAST Blended and EUCAST panel classes.
4. Do not report drug, therapy or MIC for B. pseudomallei.
9020-7493B Page 16 of 158

Amoxicillin / MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

K Clavulanate (Aug)
> R
16/8 I
8/4 S
4/2 S
2/1 S
Ampicillin (Am) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP. V. CHOLERAE
> R R
16 R I
8 S S
NOTE: 1. Enterobacteriaceae therapy based on EUCAST V3.1.
2. V. cholerae therapy based on CLSI M45-A2.
3. Use for EUCAST Blended panel class except NBC46, NM40 and NUC56 panels.
Ampicillin (Am) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP. V. CHOLERAE
> R N/R
8 S S
4 S S
2 S S
1 S S
0.5 S S
2. V. cholerae therapy based on CLSI M45-A2.
3. Use for NBC46, NM40 and NUC56 panels
6. Based on CLSI interpretive guidelines for V. cholerae, all MICs of >8 will report
as N/R, since these dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
Ampicillin (Am) MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA V. CHOLERAE

ENTEROBACTERIACEAE
> R R
16 I I
8 S S
4 S S
2 S S
NOTE: 1. Enterobacteriaceae therapy based on CLSI M100-S22 and V. cholerae therapy based on CLSI M45-
A2.
2. For Rapid fluorogenic panel MIC format, do not report drug, therapy or MIC for C. braakii/C. freundii/C.
sedlakii, C. werkmanii/C. youngae, C. amalonaticus/koseri group, Citrobacter species, Proteus/Providencia
group (except P. mirabilis) or Other Species group. See back of therapy guide for species names.
4. Do not report therapy for Aeromonas spp. and Plesiomonas shigelloides.
9020-7493B Page 17 of 158

Ampicillin (Am) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA V. CHOLERAE
> R R
16 I I
8 S S
NOTE: 1. Enterobacteriaceae therapy based on CLSI M100-S22 and V. cholerae therapy based on CLSI M45-A2.
2. Use for panels with breakpoint format.
3. For Rapid fluorogenic panel breakpoint format, do not report drug, therapy or MIC for C. braakii/C.
freundii/C. sedlakii, C. werkmanii/C. youngae, C. amalonaticus/koseri group, Citrobacter species, P.
mirabilis or M. morganii. See back of therapy guide for species names.
Ampicillin-Sulbactam MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.

(A/S) (Acinetobacter spp. only).
> R R
16/8 R I
8/4 S S
4/2 S S
2. Non-Enterobacteriaceae (Acinetobacter spp. only) therapy based on CLSI M100-S22.
3. Use for EUCAST Blended therapy panel class, except for NM40 panel.
4. Do not report drug, therapy or MIC for C. freundii group (See back of therapy guide for species names),
E. aerogenes, and E. cloacae.
Ampicillin-Sulbactam MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.

(A/S) (Acinetobacter spp. only).
> R R
8/4 S S
4/2 S S
2/1 S S
1/0.5 S S
2. Non-Enterobacteriaceae (Acinetobacter spp. only) therapy based on CLSI M100-S22.
3. Use for NM40 panel.
4. Do not report drug, therapy or MIC for C. freundii group (See back of therapy guide for species names),
E. aerogenes, and E. cloacae.
6. Based on CLSI M100-S22 interpretive guidelines for Non-Enterobacteriaceae, all MICs of >8/4 will
report as R, since these dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
Ampicillin-Sulbactam MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

(A/S) (Acinetobacter spp. only)
> R R
16/8 I I
8/4 S S
4/2 S S
2/1 S S
2. Report CLSI therapy for Enterobacteriaceae and Acinetobacter spp. See back of therapy guide for
species names.
9020-7493B Page 18 of 158

Aztreonam (Azt) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE. PSEUDOMONAS SPP.
> R R R
16 R I I
8 R S I
4 I S I
2 I S I
1 S S S
NOTE: 1. Enterobacteriaceae and Pseudomonas spp. therapies based on EUCAST V3.1.
2. Non-Enterobacteriaceae (except Pseudomonas spp.) therapy based on CLSI M100-S22.
3. Use for EUCAST Blended panel class, except for NBC45, NC53, NM40 and NUC56 panels.
4. Aztreonam is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
panels with E. coli, K. pneumoniae, and K. oxytoca. See ESBL information in front of guide.
6. Do not report therapy for Acinetobacter spp., B. cepacia, B. pseudomallei, S. maltophilia and Vibrio spp.
Aztreonam (Azt) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE. PSEUDOMONAS SPP.
> R R R
16 R I I
8 R S I
1 S S S
3. Use for NC53, NM40 and NUC56 panels.
7. Based on EUCAST interpretive guidelines for Enterobacteriaceae, all MICs of >1 will report as R, since
these dilutions do not differentiate between I and R (S≤1, I=2-4, R>4).
Aztreonam (Azt) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.
> R R R
8 R S I
1 S S S
3. Use for NBC45 panel.
7. Based on EUCAST interpretive guidelines for Enterobacteriaceae, all MICs >1 will report as R, since
8. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae (except Pseudomonas spp.), all MICs of
>8 will report as R, since these dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
9. Based on EUCAST interpretive guidelines for Pseudomonas spp., all MICs of >8 will report
as R, since these dilutions do not differentiate between I and R (S≤1, I=2-16, R>16).
9020-7493B Page 19 of 158

Aztreonam (Azt) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
32 R R
16 R I
8 R I
4 I I
2 I I
1 S S
2. Use for EUCAST panel class, except for NUC57 panel.
5. Do not report therapy for Vibrio spp.
Aztreonam (Azt) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
16 R I
8 R I
1 S S
2. Use for NUC57 panel.
6. Based on EUCAST interpretive guidelines for Enterobacteriaceae, all MICs >1 will report as R, since
Aztreonam (Azt) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
8 R S S
4 I S S
1 S S S
NOTE: 1. Enterobacteriaceae therapy based on ANVISA.
2. Non-Enterobacteriaceae and P. aeruginosa therapy based on CLSI M100-S22.
3. Use for NC66 panel.
7. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae and P. aeruginosa, all MICs of >8 will
9020-7493B Page 20 of 158

> R R R
32 R R R
16 R I I
8 I S S
4 S S S
2 S S S
1 S S S
2. Aztreonam is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried
Overnight panels with E. coli, K. pneumoniae, and K. oxytoca. See ESBL information in front of guide.
> R R R
16 R I I
8 N/R S S
2. Aztreonam is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried
Overnight panels with E. coli, K. pneumoniae, and K. oxytoca. See ESBL information in front of guide.
5. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs of ≤8 will report as N/R, since these
dilutions do not differentiate between S and I (S≤4, I=8, R≥16).
> R R R
16 I I I
8 S S S
2. Use for RNBC3 and RNUC1 panels.
3. For Rapid fluorogenic panel breakpoint format, do not report drug, therapy or MIC for P. aeruginosa.
4. Aztreonam is a screening antimicrobial agent for extended-spectrum beta-lactamases (ESBL). For Dried
Overnight panels and E. coli, K. oxytoca and K. pneumoniae see ESBL information in front of guide.
Cefazolin (Cfz) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
16 I
8 S
4 S
2 S
2. For Rapid fluorogenic panel MIC and breakpoint format, do not report drug, therapy or MIC for C.
braakii/C. freundii/C. sedlakii, C. werkmanii/C. youngae, Citrobacter species, Proteus/Providencia
group (except P. mirabilis) or Other Species group. See back of therapy guide for species names.
3. Do not report therapy for Salmonella/Shigella group or Y. pestis because dangerously misleading
results can occur.
9020-7493B Page 21 of 158

> N/R
4 S
2 S
2. Use for NC63, NC68 and NC72 panels.
3. Do not report therapy for Salmonella/Shigella group or Y. pestis because dangerously misleading
results can occur.
4. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs >4 will report as N/R, since these
dilutions do not differentiate between S, I and R (S≤8, I=16, R≥32).
Cefepime (Cpe) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.
> R R R
16 R I R
8 R S S
4 I S S
2 I S S
1 S S S
3. Use for NC58, NC70E, NC71E and NM44E panels.
5. Do not report therapy for B. cepacia, B. pseudomallei and S. maltophilia.
> R R R
8 R S S
4 I S S
2 I S S
1 S S S
0.5 S S S
3. Use for NBC46 NM40, NUC56 panels.
6. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs >8 will report as R, since these
dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
> R R R
16 R I R
8 R S S
1 S S S
3. Use for NC53 and NUC59 panels.
9020-7493B Page 22 of 158
> R R R
8 R S S
1 S S S
7. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs >8 will report as R, since
these dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
Cefepime (Cpe) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
32 R R
8 R S
4 I S
2 N/R S
4. Based on EUCAST interpretive guidelines for Enterobacteriaceae, all MICs of ≤2 will report as N/R,
since these dilutions do not differentiate between S and I (S≤1, I=2-4, R>4).
> R R
8 R S
4 I S
2 I S
1 S S
0.5 S S
> R R
8 R S
1 S S
9020-7493B Page 23 of 158

Cefepime (Cpe) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
8 R S S
4 I S S
1 S S S
2. Non-Enterobacteriaceae and P. aeruginosa therapies based on CLSI M100-S22.
6. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae and P. aeruginosa, all MICs of >8 will
> R R R
32 R R R
16 I I I
8 S S S
4 S S S
2 S S S
1 S S S
0.5 S S S
Cefixime (Cfe) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
2 R
1 S
Cefixime (Cfe) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
2 I
1 S
9020-7493B Page 24 of 158

Cefoperazone/Sulbactam MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. P. AERUGINOSA

(C/S)
> R R R
32 I I I
16 S S S
NOTE: 1. Therapy based on Manufacturers Breakpoints.
2. For Dried Overnight panels, do not report drug, therapy or MIC for S. maltophilia.
4. For Dried Overnight panels, do not report therapy for Aeromonas spp, Plesiomonas shigelloides,
Vibrio spp. and Non-Enterobacteriaceae (except Acinetobacter spp. and P. aeruginosa).
Cefotaxime (Cft) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE
> R R
32 R I
16 R I
8 R S
4 R S
2 I S
1 S S
2. Non-Enterobacteriaceae (including Acinetobacter spp. and Pseudomonas spp.) therapy based on CLSI
M100-S22.
3. Use for EUCAST Blended panel class, except for NBC46, NC70E, NC71E, NM40, NUC56 and
NUC69E panels.
4. Do not report drug, therapy or MIC for M. morganii and Serratia spp.
5. Cefotaxime is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
panels with E. coli, K. pneumoniae, K. oxytoca and P. mirabilis. See ESBL information in front of guide.
7. Do not report therapy for B. cepacia, B. pseudomallei, and S. maltophilia.
8. Based on CLSI M100-S22, do not report therapy for P. aeruginosa.
Cefotaxime (Cft) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE
> R N/R
16 R I
8 R S
4 R S
2 I S
1 S S
0.5 S S
2. Non-Enterobacteriaceae (including Acinetobacter spp. and Pseudomonas spp.) therapy based on CLSI
M100-S22.
3. Use for NBC46, NC70E, NM40, NUC56 and NUC69E panels.
9. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs of >16 will report as N/R,
since these dilutions do not completely differentiate between I and R (S≤8, I=16-32, R≥64).
9020-7493B Page 25 of 158

Cefotaxime (Cft) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
16 R
2 I
1 S
0.5 S
2. Use for EUCAST panel class, except for NC48 panel.
Cefotaxime (Cft) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
32 R
8 R
4 R
2 N/R
6. Based on EUCAST interpretive criteria for Enterobacteriaceae, all MICs of ≤2 will report as N/R, since
these dilutions do not differentiate between S and I (S≤1, I=2, R>2).
Cefotaxime (Cft) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R
32 R I
16 R I
8 N/R S
3. Use for NC71C and NC71E panels.
8. Based on CLSI interpretive breakpoints for Enterobacteriaceae, all MICs of ≤8 will report as N/R, since
these dilutions do not differentiate between S, I and R (S≤1, I=2, R≥4).
9020-7493B Page 26 of 158

> R R
64 R R
32 R I
16 R I
8 R S
4 R S
2 I S
1 S S
> R N/R
16 R I
8 R S
4 R S
2 I S
1 S S
3. Use for NC66, NC70C and NUC69C panels
5. Do not report therapy for B. cepacia, B. pseudomallei, P. aeruginosa and S. maltophilia.
7. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs of >16 will report as N/R, since
these dilutions do not completely differentiate between I and R (S≤8, I=16-32, R≥64).
> R R
32 R I
16 R I
8 R S
4 R S
2 N/R S
6. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs of ≤2, will report as N/R, since these
9020-7493B Page 27 of 158

> R R
32 R I
16 R I
8 R S
4 N/R S
> R R
32 R I
8 N/R S
> R R
32 I I
16 I I
8 S S
4 S S
>
16
2
NOTE: 1. Cefotaxime is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
9020-7493B Page 28 of 158

Cefotaxime-K MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

Clavulanate (Cft/CA)
>
16/4
8/4
4/4
2/4
1/4
0.5/4
0.25/4
NOTE: 1. Cefotaxime/4 K Clavulanate is a confirmation antimicrobial for extended-spectrum beta-
lactamases (ESBL) on Dried Overnight panels. See ESBL information in front of guide.
Cefotetan (Ctn) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
32 I
16 S
8 S
4 S
2. Do not report therapy for Salmonella/Shigella group or Y. pestis because dangerously misleading results can
occur.
Cefoxitin (Cfx) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
32 I
8 S
4 S
2 S
NOTE: 1. Therapy based on SFM 2012.
> R
32 R
16 I
8 S
4 S
2 S
occur.
9020-7493B Page 29 of 158

> R
8 S
2. Use for NBC49C, NBC49E, NBC42, NBC46 and NUC56 panels.
occur.
4. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs of >8 will report as R, since these
Cefpodoxime (Cpd) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R
1 S
0.5 S
2. Use for EUCAST Blended panel class, except for NBC46 panel.
3. Do not report drug, therapy or MIC for S. marcescens.
4. Cefpodoxime is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
panels with E. coli, K. oxytoca, K. pneumoniae, and P. mirabilis. See ESBL information in front of guide.
Cefpodoxime (Cpd) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
4 I
2 S
1 S
2. Cefpodoxime is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
Cefpodoxime (Cpd) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
>
1
NOTE: 1. Cefpodoxime is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
panels with E. coli, K. pneumoniae, K. oxytoca, and P. mirabilis . See ESBL information in front of guide.
Cefsulodin (Cfs) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
>
32
8
9020-7493B Page 30 of 158

Ceftazidime (Caz) MIC ENTEROBACTERIACEAE NON- PSEUDOMONAS SPP. B. PSEUDOMALLEI

ENTEROBACTERIACEAE
> R R R R
32 R R R R
16 R I R I
8 R S S S
4 I S S S
2 I S S S
1 S S S S
2. Non-Enterobacteriaceae (except Pseudomonas spp. and B. pseudomallei) including Acinetobacter spp.
therapy based on CLSI M100-S22 and B. pseudomallei therapy based on CLSI M45-A2.
3. Use for EUCAST Blended panel class, except for NBC45, NBC46, NC70E, NM40 and NUC56 panels.
4. Ceftazidime is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
panels with E. coli, K. oxytoca, K. pneumoniae, and P. mirabilis. See ESBL information in front of therapy guide.
Ceftazidime (Caz) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP. B. PSEUDOMALLEI
> R R R N/R
8 R S S S
4 I S S S
2 I S S S
1 S S S S
0.5 S S S S
3. Use for NBC46, NC70E, NM40 and NUC56 panels.
6. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae all MICs >8 will report as R, since these
dilutions do not differentiate between I and R (S≤8, I=16, R>32).
7. Based on CLSI interpretive guidelines for B. pseudomallei, all MICs >8 will report as N/R, since these dilutions
do not differentiate between I and R (S≤8, I=16, R≥32).
Ceftazidime (Caz) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP. B. PSEUDOMALLEI
> N/R R R R
16 N/R I R I
8 N/R S S S
1 S S S S
panels with E. coli, K. oxytoca, K. pneumoniae, and P. mirabilis. See ESBL information in front of therapy guide.
6. Based on EUCAST interpretive guidelines for Enterobacteriaceae, all MICs >1 will report as N/R, since
9020-7493B Page 31 of 158

Ceftazidime (Caz) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
32 R R
16 R R
8 R S
4 I S
2 I S
1 S S
0.5 S S
Ceftazidime (Caz) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA B.PSEUDOMALLE

ACINETOBACTER SPP. I
> R R R R
16 R I I I
8 R S S S
4 I S S S
1 S S S S
2. Non-Enterobacteriaceae and P. aeruginosa therapies based on CLSI M100-S22 and B. pseudomallei
therapy based on CLSI M45-A2.
Ceftazidime (Caz) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA B. PSEUDOMALLEI
> R R R R
128 R R R R
64 R R R R
32 R R R R
16 R I I I
8 I S S S
4 S S S S
2 S S S S
1 S S S S
NOTE: 1. Therapy based on CLSI M100-S22 and B. pseudomallei therapy based on CLSI M45-A2.
9020-7493B Page 32 of 158


> R R R N/R
8 I S S S
4 S S S S
2 S S S S
1 S S S S
2. Use for NC70C panel.
5. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae and P. aeruginosa, all MICs of >8
will report as R, since these dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
6. Based on CLSI interpretive guidelines for B. pseudomallei, all MICs of >8 will report as N/R, since these
> R R R R
16 R I I I
8 N/R S S S
4. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs of ≤8 will report as N/R, since
these dilutions do not differentiate between S and I (S≤4, I=8, R≥16).
> R R R R
16 I I I I
8 S S S S
4 S S S S
2 S S S S
2. Use for RNUC1 panel.
3. For Rapid fluorogenic panel MIC format, do not report drug, therapy or MIC for P. mirabilis and M.
morganii.
> R R R R
16 I I I I
8 S S S S
2. Use for RNBP3 panels.
9020-7493B Page 33 of 158

>
8
1
NOTE: 1. Ceftazidime is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
Ceftazidime-K MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

Clavulanate (Caz/CA)
>
32/4
16/4
8/4
4/4
2/4
1/4
0.5/4
0.25/4
NOTE: 1. Ceftazidime/4 µg/ml K Clavulanate is a confirmation antimicrobial for extended-spectrum beta-
lactamases (ESBL) on Dried Overnight panels. See ESBL information in front of therapy guide.
Ceftizoxime (Cz) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R
32 I I
8 S S
3. Do not report therapy for Acinetobacter spp., Aeromonas spp., B. cepacia, B. pseudomallei,
Plesiomonas shigelloides, S. maltophilia and Vibrio spp.
4. Do not report therapy for P. aeruginosa.
Ceftriaxone (Cax) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS

SPP.
> R N/R
2 I S
1 S S
0.5 S S
2. Non-Enterobacteriaceae therapy based on CLSI M100-S22.
3. Use for EUCAST Blended panel class.
4. Ceftriaxone is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried
Overnight panels with E. coli, K. oxytoca and K. pneumoniae. See ESBL information in front of therapy guide.
6. Do not report therapy for B. cepacia, B. pseudomallei, P. aeruginosa, S. maltophilia, and Vibrio spp.
7. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs >2 will report as N/R since
these dilutions do not differentiate between S, I and R (S≤8, I=16-32, R≥64).
9020-7493B Page 34 of 158

Ceftriaxone (Cax) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R
32 R I
8 R S
2 I S
1 S S
2. Ceftriaxone is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight
panels with E. coli, K. oxytoca and K. pneumoniae. See ESBL information in front of therapy guide.
> R N/R
8 R S
4 R S
2 I S
1 S S
since these dilutions do not differentiate between I and R (S≤8, I=16-32, R≥64).
> R R
32 R I
16 R I
8 R S
4 R S
2 N/R S
9020-7493B Page 35 of 158

> R R
32 R I
16 R I
8 R S
4 N/R S
> R R
32 R I
16 R I
8 N/R S
> R R
32 I I
16 I I
8 S S
4 S S
2. Use for RNUC1 panel.
3. For Rapid fluorogenic panel MIC format, do not report drug, therapy or MIC for P. aeruginosa.
5. Do not report therapy for B. cepacia, B. pseudomallei, S. maltophilia, and Vibrio spp.
> R R
32 I I
8 S S
2. Use for RNBP3 panel.
4. Do not report therapy for B. cepacia, B. pseudomallei, S. maltophilia, and Vibrio spp.
9020-7493B Page 36 of 158

Cefuroxime (Crm) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
16 R
8 S
4 S
2 S
1 S
3. Report therapy for E. coli, P. mirabilis, and Klebsiella spp. only.
4. Do not report therapy for Salmonella/Shigella group and Y. pestis because dangerously misleading
results can occur.
Cefuroxime sodium (Crm) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

(parenteral)
> R
16 I
8 S
4 S
2 S
1 S
2. For Rapid fluorogenic panel MIC format, do not report drug, therapy or MIC for Proteus/Providencia group
(except P. mirabilis) or Other Species groups. See back of therapy guide for species names.
3. Do not report therapy for Salmonella/Shigella group and Y. pestis because dangerously misleading results
can occur.
4. The CLSI breakpoints for Cefuroxime axetil (oral) are S≤4, I=8-16, R≥32.

(parenteral)
> R
16 I
8 S
2. Use for NC66, NC70C and NUC69C panels.
3. Do not report therapy for Salmonella/Shigella group and Y. pestis because dangerously misleading results can
occur.
4. The CLSI breakpoints for Cefuroxime axetil (oral) and Enterobacteriaceae are S≤4, I=8-16, R≥32;
based on these breakpoints, panel dilutions do not differentiate between S and I.
Cephalothin (Cf) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
32 I
16 I
8 S
9020-7493B Page 37 of 158

> R
16 I
8 S
4 S
2 S
2. Report for urine sources only.
results can occur.
> N/R
8 S
3. Report for urine sources only.
results can occur.
6. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs of >8 will report as N/R, since
Chloramphenicol (C) MIC ENTEROBACTERIACEAE NON- P. V. CHOLERAE Y. PESTIS

ENTEROBACTERIACEAE AERUGINOSA
> R R R R
16 R I I I
8 S S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis) therapy based on EUCAST V3.1.
2. Non-Enterobacteriaceae therapy based on CLSI M100-S22 and V. cholerae and Y. pestis therapies
based on CLSI M45-A2.
3. Use for NM44E panel.
4. Only systemic therapy will be reported.
5. Do not report drug, therapy or MIC for E. cloacae, M. morganii, P. mirabilis and S. marcescens.
6. Do not report therapy for Acinetobacter spp. and B. pseudomallei.
ChloramphenicoI (C) MIC ENTEROBACTERIACEAE NON- P. V. Y. PESTIS

ENTEROBACTERIACEAE AERUGINOSA CHOLERAE
> R N/R N/R N/R
8 S S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis) therapy based on EUCAST V3.1.
2. Non-Enterobacteriaceae therapy based on CLSI M100-S22 and V. cholerae and Y. pestis therapies
based on CLSI M45-A2.
3. Use for NBC46 and NM40 panels.
5. Do not report drug, therapy or MIC for E. cloacae, M. morganii, P. mirabilis and S. marcescens.
6. Do not report therapy for Acinetobacter spp. and B. pseudomallei.
7. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, V. cholerae and Y. pestis, all MICs
of >8 will report as N/R, since these dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
9020-7493B Page 38 of 158

ChloramphenicoI (C) MIC ENTEROBACTERIACEAE NON- P. V. CHOLERAE Y. PESTIS

> R R R R
16 I I I I
8 S S S S
4 S S S S
NOTE: 1. Enterobacteriaceae (except V. cholerae and Y. pestis) and Non-Enterobacteriaceae therapies based on CLSI
M100-S22 and V. cholerae and Y. pestis therapies based on CLSI M145-A2.
3. Do not report therapy for Acinetobacter spp., B. pseudomallei and Vibrio spp.
Cinoxacin (Cn) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA Y. PESTIS
> N/R
16 S
2. Use for RNB3 panel.
3. Only urine therapy will be reported.
4. Do not report therapy for Aeromonas spp., Plesiomonas shigelloides, Vibrio spp. and Y. pestis.
5. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs of >16 will report as N/R, since
Ciprofloxacin (Cp) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS Y. PESTIS

SPP.
> R R R R
2 R I R I
1 I S I S
0.5 S S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis) and Pseudomonas spp. therapies based on EUCAST V3.1.
2. Non-Enterobacteriaceae (except Pseudomonas spp.) including Acintobacter spp. therapy based on
CLSI M100-S22 and Y. pestis therapy based on CLSI M100-S17.
3. Use for EUCAST Blended panel class, except for NBC45, NBC46, NBC49E (use CLSI M100-S21
breakpoints), NM40 and NUC56 panels.
5. Panel dilutions do not allow reporting of EUCAST breakpoints for Salmonella spp.
Ciprofloxacin (Cp) MIC ENTEROBACTERIACEAE NON- PSEUDOMONAS Y. PESTIS

> R N/R R N/R
1 I S I S
0.5 S S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis) and Pseudomonas spp. therapies based on EUCAST V3.1.
2. Non-Enterobacteriaceae (except Pseudomonas spp.) therapy including Acintobacter spp. based on
CLSI M100-S22 and Y. pestis therapy based on CLSI M100-S17.
3. Use for NBC45, NBC46, NM40 and NUC56 panels.
6. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae and Y. pestis, all MICs of >1 will
report as N/R, since these dilutions do not differentiate between I and R (S≤1, I=2, R≥4).
9020-7493B Page 39 of 158

Ciprofloxacin (Cp) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
2 R R
1 I I
0.5 S S
0.25 S S
3. Do not report drug, therapy or MIC for Acinetobacter spp.
Ciprofloxacin (Cp) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA Y. PESTIS
> R R R R
4 R R R R
2 I I I I
1 S S S S
0.5 S S S S
0.12 S S S S
2. Therapy for Y. pestis based on CLSI M100-S17.
Colistin (Cl) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R R
4 R S
2 S S
2. Use for EUCAST Blended panel class, except for NM40 panel.
4. Do not report drug, therapy or MIC for Salmonella species, E. cloacae, Acinetobacter species or Other
Non-Enterobacteriaceae (except Pseudomonas spp).
Colistin (Cl) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R R
2 S S
4. Based on EUCAST interpretive guidelines for Pseudomonas spp., all MICs >2 will report as R, since
these dilutions do not differentiate between S and R (S≤4, R>4).
Non-Enterobacteriaceae (except Pseudomonas spp).
9020-7493B Page 40 of 158

Colistin (Cl) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
4 R S
2 S S
2. Use for EUCAST panel class, except for NM39 panel.
4. Do not report drug, therapy or MIC for Salmonella species, E. cloacae or Acinetobacter species.
> R R
2 S S
4. Based on EUCAST interpretive guidelines for Pseudomonas spp., all MICs of >2 will report as R, since
Colistin (Cl) MIC ENTEROBACTERIACEAE NON- ACINETOBACTER P. AERUGINOSA

> R R
4 R I
2 S S
2. P. aeruginosa therapy based on CLSI M100-S22.
4. Do not report therapy for B. cepacia, S. maltophilia and Y. pestis.
Non-Enterobacteriaceae.
Colistin (Cl) MIC ENTEROBACTERIACEAE NON- ACINETOBACTER P. AERUGINOSA

> R
4 I
2 S
2. Do not report therapy for B. cepacia, S. maltophilia and Y. pestis.
3. Do not report drug, therapy or MIC for Acinetobacter species or Other Non-Enterobacteriaceae.
Doripenem (Dor) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R R
4 I I I
2 I I I
1 S S S
4. Do not report drug, therapy, or MIC for Aeromonas spp., Plesiomonas shigelloides, and Vibrio spp.
(including V. cholerae).
9020-7493B Page 41 of 158

Doripenem (Dor) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R
4 R I
2 I S
1 S S
2. Use for NM44C and NC71C panels.
Doripenem (Dor) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R
2 I S
1 S S
0.5 S S
3. Based on CLSI interpretive guidelines for P. aeruginosa, all MICs of >2 will report as R, since these
dilutions do not differentiate between I and R (S≤2, I=4, R≥ 8).
Ertapenem (Etp) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
4 R
2 R
1 I
0.5 S
Ertapenem (Etp) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
1 I
0.5 S
NOTE: 1. Therapy based on ANVISA.
9020-7493B Page 42 of 158

Ertapenem (Etp) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
4 R
2 R
1 I
0.5 S
4. Enterobacteriaceae that are resistant to extended spectrum cephalosporins (3rd generation) and have
Ertapenem MICs of >1 may produce KPC-type or other carbapenemases. The isolate should be saved
and results verified by repeat testing unless patient had isolate previously. Follow current CLSI or
public health guidelines. Infectious Disease Consult suggested.
> R
4 R
2 R
1 N/R
2. Use for NBC43, NBC44, NBC47, NM38, NUC55, NUC60, NUC61 and NUC62 panels.
these dilutions do not differentiate between S and I (S≤0.5, I=1, R≥2).
> R
4 R
2 N/R
2. Use for NBC33, NBC34, NBC39, NBC41, NBC42, NC39, NC50, NUC45 and NUC51 panels.
these dilutions do not differentiate between S and I (S≤0.5, I=1, R≥2).
9020-7493B Page 43 of 158

>
1
3. Per CLSI, Enterobacteriaceae that are resistant to extended spectrum cephalosporins (3rd generation)
and have Ertapenem MICs of >1 may produce KPC-type or other carbapenemases. The isolate should
be saved and results verified by repeat testing unless patient had isolate previously. Follow current
CLSI or public health guidelines. Infectious Disease Consult suggested.
ESBL-a (ESa) MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA

ENTEROBACTERIACEAE
>
4
NOTE: 1. ESBL-a is Cefpodoxime.
2. ESBL-a is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight panels
with E. coli, K. oxytoca, K. pneumoniae, and P. mirabilis. See ESBL information in front of the guide.
ESBL-b (ESb) MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA

ENTEROBACTERIACEAE
>
1
NOTE: 1. ESBL-b is Ceftazidime.
2. ESBL-b is a screening antimicrobial for extended-spectrum beta-lactamases (ESBL) on Dried Overnight panels
with E. coli, K. oxytoca, K. pneumoniae, and P. mirabilis. See ESBL information in front of the guide.
Fosfomycin (Fos) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
64 R
32 S
16 S
2. Use for EUCAST blended, EUCAST panel classes and NBC42, NBC43, NC54 and NM37 panels.
3. Do not report therapy for Aeromonas spp., Plesiomonas shigelloides, Vibrio spp., and Y. pestis.
4. Anecdotal evidence suggests that infections caused by wild type isolates of Pseudomonas spp. (ECOFF:
WT≤128mg/L) may be treated with combination of fosfomycin and other agents.
> R
64 N/R
3. Anecdotal evidence suggests that infections caused by wild type isolates of Pseudomonas spp. (ECOFF:
WT≤128mg/L) may be treated with combination of fosfomycin and other agents.
4. Based on EUCAST interpretive guidelines for Enterobacteriaceae, all MICs of ≤64 will report as N/R, since
9020-7493B Page 44 of 158

Gatifloxacin (Gat) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
4 I
2 S
NOTE: 1. Therapy based on FDA approved breakpoints.
2. For Dried Overnight panels, do not report drug, therapy or MIC for Non-Enterobacteriaceae and P.
aeruginosa.
Gemifloxacin (Gem) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
0.5 I
0.25 S
Gentamicin MIC ENTEROBACTERIACEAE NON- ACINETOBACTER PSEUDOMONAS Y. PESTIS

ENTEROBACTERIACEAE SPP. SPP.
(Gm)
> R R R R R
8 R I R R I
4 I S S S S
2 S S S S S
1 S S S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis), Acinetobacter spp. and Pseudomonas spp. therapies based on
EUCAST.
2. Non-Enterobacteriaceae (except Pseudomonas spp. and Acinetobacter spp.) therapy based on CLSI
M100-S22 and Y. pestis therapy based on M45-A2.
4. Do not report therapy for Salmonella/Shigella group because dangerously misleading results can occur.
Gentamicin MIC ENTEROBACTERIACEAE NON- ACINETOBACTER PSEUDOMONAS Y. PESTIS

(Gm)
> R R R R R
4 I S S S S
2 S S S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis), Acinetobacter spp. and Pseudomonas spp. therapies based on
EUCAST V3.1.
2. Non-Enterobacteriaceae (except Pseudomonas spp. and Acinetobacter spp.) therapy based on CLSI
M100-S22 and Y. pestis therapy based on M45-A2.
6. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae and Y. pestis, all MICs of >4 will
report as R, since these dilutions do not differentiate between S and I (S≤4, I=8, R≥16).
9020-7493B Page 45 of 158

Gentamicin (Gm) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R R
8 R R R
4 I S S
2 S S S
1 S S S
Gentamicin (Gm) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA Y. PESTIS
> R R R R
8 I I I I
4 S S S S
2 S S S S
1 S S S S
Imipenem MIC ENTEROBACTERIACEAE NON- ACINETOBACTER PSEUDOMONAS B. PSEUDOMALLEI

(Imp)
> R R R R R
8 I I - I I
4 I S - S S
2 S S - S S
1 S S - S S
2. Non-Enterobacteriaceae (except Acinetobacter spp and Pseudomonas spp.) therapy based on CLSI
M100-S22 and B. pseudomallei therapy based on CLSI M45-A2.
5. For Acinetobacter spp., susceptible and intermediate results will not be reported.
6. For Dried Overnight panels, do not report therapy for B. cepacia and S. maltophilia.
Imipenem (Imp) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R R
8 I - I
4 I - S
2 S - S
1 S - S
0.5 S - S
9020-7493B Page 46 of 158

Imipenem (Imp) MIC ENTEROBACTERIACEAE NON- P. B. PSEUDOMALLEI

> R R R R
8 R I R I
4 R S I S
2 I S S S
1 S S S S
2. Non-Enterobacteriaceae and P. aeruginosa therapies based on CLSI M100-S22 and B. pseudomallei
therapy based on CLSI M45-A2.
5. Do not report therapy for B. cepacia and S. maltophilia, Aeromonas spp., Plesiomonas shigelloides and
Vibrio spp.

> R R R R
8 R I R I
4 R S I S
2 I S S S
1 S S S S
2. For Rapid fluorogenic panels, do not report drug, therapy or MIC for all gram-negative organisms.
3. For Dried Overnight panels, do not report therapy for Y. pestis because dangerously misleading results can
occur.
4. For Dried Overnight panels, do not report therapy for B. cepacia, S. maltophilia, Aeromonas spp.,
Plesiomonas shigelloides and Vibrio spp.

> R R R R
8 R I R I
4 R S I S
2 N/R S S S
occur.
9020-7493B Page 47 of 158


> R R R R
8 R I R I
4 N/R S N/R S
occur.
7. Based on CLSI interpretive guidelines for P. aeruginosa, all MICs of ≤4 will report as N/R, since these
Levofloxacin (Lvx) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R R R R
4 R I R R
2 I S I I
1 S S S S
2. Non-Enterobacteriaceae (except Acinetobacter spp. and Pseudomonas spp.) therapy based on CLSI
M100-S22.
3. Use for EUCAST Blended panel class, except for NBC45, NBC46, NBC49E, NM40 and NUC56
panels.
4. Do not report therapy for B. pseudomallei and Y. pestis.
Levofloxacin (Lvx) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R R R R
2 I S I I
1 S S S S
M100-S22.
5. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs of >2 will report as R,
since these dilutions do not differentiate between S, I and R (S≤2, I=4, R≥8).
Levofloxacin (Lvx) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
4 I I I
2 S S S
1 S S S
0.5 S S S
9020-7493B Page 48 of 158

Mecillinam (Mec) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
8 S
2. Use for EUCAST blended and EUCAST panel classes.
4. For Dried Overnight panels, do not report drug, therapy or MIC for Klebsiella spp.
Meropenem (Mer) MIC ENTEROBACTERIACEAE NON- ACINETOBACTER PSEUDOMONAS

> R R R R
8 I I I I
4 I S I I
2 S S S S
1 S S S S
0.5 S S S S
M100-S22.
5. Do not report therapy for B. pseudomallei and S. maltophilia.
Meropenem (Mer) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
8 R I R
4 R S I
2 I S S
1 S S S
2. Non-Enterobacteriaceae and P aeruginosa therapies based on CLSI M100-S22.
> R R R
8 R I R
4 R S I
2 I S S
1 S S S
3. Do not report therapy for Aeromonas spp., B. pseudomallei, Plesiomonas shigelloides, S. maltophilia,
and Vibrio spp.
9020-7493B Page 49 of 158

> R R R
8 R I R
4 R S I
1 S S S
2. Use for NBC42 and NBC43 panels.
and Vibrio spp.
5. Based on CLSI interpretive guidelines for Enterobacteriaceae, all MICs of >1 will report as R, since
> R R R
16 R R R
8 R I R
4 R S I
2 N/R S S
and Vibrio spp.
> R R R
8 R I R
4 N/R S N/R
and Vibrio spp.
5. Based on CLSI interpretive guidelines for P. aeruginosa, all MICs of ≤4 will report as N/R, since these
9020-7493B Page 50 of 158

Mezlocillin (Mz) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
64 I I S
32 I I S
16 S S S
8 S S S
2. For Rapid fluorogenic panel MIC format, do not report drug, therapy or MIC for Serratia group. See back of
therapy guide for species names.
4. For Rapid fluorogenic panels, do not report therapy for S. maltophilia.
6. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, Plesiomonas shigelloides and Vibrio
spp.
Minocycline (Min) MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA

ENTEROBACTERIACEAE
> R R
8 I I
4 S S
2 S S
1 S S
2. Do not report therapy Aeromonas spp., B. pseudomallei, Plesiomonas shigelloides, Vibrio spp, and Y.
pestis.
Moxifloxacin (Mxf) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
2 R
1 I
0.5 S
2. Use for the EUCAST Blended panel class and NBC42, NBC49C and NM37 panels.
3. Do not report drug, therapy or MIC for P. aeruginosa.
5. Do not report therapy for Aeromonas spp, Plesiomonas shigelloides, Vibrio spp. and Y. pestis.
Moxifloxacin (Mxf) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
4 I
2 S
9020-7493B Page 51 of 158

Nalidixic Acid (NA) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
16 I
8 S
4 S
4. For Dried Overnight panels, do not report drug, therapy or MIC for E. cloacae and K. pneumoniae.
5. Do not report therapy for Salmonella because the ability of the dried gram negative panels to detect
Nalidixic Acid resistance in Salmonella strains is unknown, resistant strains were not available at the
time of comparative testing. An alternate method should be used.
Nalidixic Acid (NA) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
16 S
3. For Dried Overnight panels, do not report drug, therapy or MIC for E. cloacae and K. pneumoniae.
5. Do not report therapy for Salmonella because the ability of the dried gram negative panels to detect
6. Do not report therapy for Aeromonas spp., Plesiomonas shigelloides, and Vibrio spp.
Netilmicin (Nt) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
16 I I I
8 S S S
4 S S S
2 S S S
3. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, Plesiomonas shigelloides, S.
maltophilia, Vibrio spp. and Y. pestis.
Nitrofurantoin (Fd) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R
64 S
32 S
9020-7493B Page 52 of 158

Nitrofurantoin (Fd) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
64 I
32 S
Norfloxacin (Nxn) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
1 I S S
0.5 S S S
Plesiomonas shigelloides, S. maltophilia, Vibrio spp. and Y. pestis.
6. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae and P. aeruginosa, all MICs of >1
will report as R, since these dilutions do not differentiate between S, I and R (S≤4, I=8, R≥16).
Norfloxacin (Nxn) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
1 I
0.5 S
> R R R
8 I I I
4 S S S
1 S S S
0.5 S S S
9020-7493B Page 53 of 158

Ofloxacin Ofl) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
1 I S S
0.5 S S S
Plesiomonas shigelloides, S. maltophilia and Y. pestis.
5. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae and P. aeruginosa , all MICs of
>1 will report as R, since these dilutions do not differentiate between S, I and R (S≤2, I=4, R≥8).
Ofloxacin (Ofl) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R
4 R
2 R
1 I
0.5 S
3. Do not report therapy for Aeromonas spp., Plesiomonas shigelloides and Y. pestis.
Ofloxacin (Ofl) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
4 I I I
2 S S S
1 S S S
0.5 S S S
Plesiomonas shigelloides, S. maltophilia and Y. pestis.
Ofloxacin (Ofl) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
4 I I I
2 S S S
2. For Rapid fluorogenic panel breakpoint format, do not report drug, therapy or MIC for A. baumannii, A.
haemolyticus, A. baumannii/haemolyticus, Acinetobacter spp. or P. aeruginosa. See back of therapy
guide for species names.
maltophilia and Y. pestis.
4. For Dried Overnight panels, do not report therapy for Acinetobacter spp.
9020-7493B Page 54 of 158

Piperacillin (Pi) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.
> R R R
64 R I R
16 I S S
8 S S S
4. Do not report drug, therapy or MIC for C. koseri and S. maltophilia.
6. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, and Plesiomonas shigelloides.
Piperacillin (Pi) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.
> R N/R R
16 I S S
8 S S S
4 S S S
6. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, and Plesiomonas shigelloides.
Piperacillin (Pi) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
64 R R
16 I S
8 S S
Piperacillin (Pi) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
128 R R R
64 I I I
32 I I I
16 S S S
8 S S S
3. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, and Plesiomonas
shigelloides.
4. Do not report drug, therapy or MIC for S. maltophilia.
9020-7493B Page 55 of 158

> R R R
64 I I S
16 S S S
4. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, Plesiomonas shigelloides and S.
maltophilia.
Piperacillin-Tazobactam MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.

(P/T)
> R R R
64 R I R
32 R I R
16 I S S
8 S S S
4. Do not report drug, therapy or MIC for S. maltophilia and Acinetobacter species. See back of therapy
6. Do not report therapy for B. cepacia and B. pseudomallei.
Piperacillin-Tazobactam MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.

(P/T)
> R R R
16 I S S
8 S S S
4 S S S
7. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs of >16 will report as R,
Piperacillin-Tazobactam MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.

(P/T)
> R R
64 R R
16 I S
8 S S
4 S S
9020-7493B Page 56 of 158
Piperacillin-Tazobactam MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

(P/T)
> R R R
64 I I I
32 I I I
16 S S S
8 S S S
2. For Dried Overnight panels, do not report drug, therapy or MIC for S. maltophilia and Acinetobacter
species. See back of therapy guide for species names.
Tetracycline (Te) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R
8 I I
4 S S
2. Use for EUCAST blended and EUCAST panel classes.
Tetracycline (Te) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA V. CHOLERAE
> R R R
8 I I I
4 S S S
2 S S S
MIC B. PSEUDOMALLEI Y. PESTIS

> R R
8 I I
4 S S
2 S S
NOTE: 1. Enterobacteriaceae (except V. cholerae and Y. pestis) and Non-Enterobacteriaceae (except B.
pseudomallei) therapies based on CLSI M100-S22. V. cholerae, Y. pestis and B. pseudomallei
therapies based on CLSI M45-A2.
2. Do not report therapy for B. cepacia and S. maltophilia.
Ticarcillin (Ti) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.
> R N/R R
32 R I R
16 I S S
8 S S S
3. Use for EUCAST Blended panel class, except for NC71E (use CLSI M100-S21 breakpoints) panel.
6. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, Plesiomonas shigelloides and
Vibrio spp.
9020-7493B Page 57 of 158

Ticarcillin (Ti) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
64 R R
32 R R
16 I S
8 S S
> R R
64 R R
16 N/R S
since these dilutions do not differentiate between S and I (S≤8, I=16, R>16).
Ticarcillin (Ti) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
64 I I S
32 I I S
16 S S S
4. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, Plesiomonas shigelloides and
Vibrio spp.
Ticarcillin (Ti) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
64 I I S
16 S S S
NOTE: 1. Therapy based on CLSI M100- S21.
maltophilia and Vibrio spp.
9020-7493B Page 58 of 158

Ticarcillin- MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS

SPP.
K Clavulanate (Tim)
> R R
16 I S
8 S S
4. Do not report therapy for Aeromonas spp, Plesiomonas shigelloides and Vibrio spp.
5. Do not report drug, therapy or MIC for Non-Enterobacteriacea (other than Pseudomonas species).
Ticarcillin- MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
K Clavulanate (Tim)
> R R
64 R R
32 R R
16 I S
8 S S
Ticarcillin- MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
K Clavulanate (Tim)
> R R
64 R R
16 N/R S
Ticarcillin- MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

K Clavulanate (Tim)
> R R
64 I I
32 I I
16 S S
8 S S
2. Do not report drug, MIC or therapy for P. aeruginosa.
4. Do not report therapy for Aeromonas spp., B. pseudomallei, Plesiomonas shigelloides and Vibrio spp.
9020-7493B Page 59 of 158


K Clavulanate (Tim)
> R R
64 I I
16 S S
2. Use for RNBC3 panel.
3. For Rapid fluorogenic panel breakpoint format, do not report drug, therapy or MIC for P. aeruginosa, E. coli or
Klebsiella spp. See back of therapy guide for species names.
5. Do not report therapy for Aeromonas spp., B. pseudomallei, Plesiomonas shigelloides, and Vibrio spp.
Tigecycline (Tgc) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R
4 R
2 I
1 S
0.5 S
0.25 S
2. Use for EUCAST Blended, EUCAST panel classes, and NBC42, NBC43, NBC49C, NC54, NC70C,
NC71C, NM44C panels.
3. Do not report drug, therapy or MIC for Acinetobacter spp., P. mirabilis, Non-Enterobacteriaceae and P.
aeruginosa.
Tigecycline (Tgc) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
2 I
1 S
aeruginosa.
Tigecycline (Tgc) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
4 I
2 S
1 S
aeruginosa.
9020-7493B Page 60 of 158

Tobramycin (To) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R R R R
8 R I R R
4 I S S S
2 S S S S
M100-S22.
4. Do not report therapy for Salmonella/Shigella group because dangerously misleading results can
occur.
Tobramycin (To) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

SPP.
> R R R R
4 I S S S
2 S S S S
2. Non-Enterobacteriaceae (except Acinetobacter spp. and Pseudomonas spp.) therapies based on CLSI
M100-S22.
6. Based on CLSI interpretive guidelines for Non-Enterobacteriaceae, all MICs of >4 will report as R, since
Tobramycin (To) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R R
8 R R R
4 I S S
2 S S S
1 S S S
Tobramycin (To) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
16 R R R
8 I I I
4 S S S
2 S S S
1 S S S
3. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, Plesiomonas shigelloides,
S. maltophilia, Vibrio spp. and Y. pestis.
9020-7493B Page 61 of 158

Trimethoprim (T) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA .
> R
8 S
3. For Rapid fluorogenic panel breakpoint format, do not report drug, therapy or MIC for A. baumannii, A.
haemolyticus, A. baumannii/haemolyticus and Acinetobacter spp. See back of therapy guide for
species names.
Trimethoprim- MIC ENTEROBACTERIACEAE NON- ACINETOBACTER P. AERUGINOSA

Sulfamethoxazole
(T/S)
> R R R
4/76 I R I
2/38 S S S
MIC B. PSEUDOMALLEI V. CHOLERAE S. MALTOPHILIA Y. PESTIS

> R R R R
4/76 R R S R
2/38 S S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis), Acinetobacter spp. and S. maltophilia therapies based on
EUCAST.
2. Non-Enterobacteriaceae (including Pseudomonas spp. other than P. aeruginosa) therapy based on
CLSI M100-S22 and B. pseudomallei, V. cholerae, and Y. pestis therapies based on CLSI M45-A2.
3. Use for EUCAST blended panel class, except for NC53 and NC58 panels.
Trimethoprim- MIC ENTEROBACTERIACEAE NON- ACINETOBACTER P. AERUGINOSA S. MALTOPHILIA

Sulfamethoxazole
(T/S)
> R R R R
2/38 S S S S
MIC B. PSEUDOMALLEI V. CHOLERAE Y. PESTIS

> R R R
2/38 S S S
NOTE: 1. Enterobacteriaceae (except Y. pestis), Acinetobacter spp. and S. maltophilia therapies based on
EUCAST V3.1.
2. Non-Enterobacteriaceae (including Pseudomonas spp. other than P. aeruginosa) therapy based on
CLSI M100-S22 and B. pseudomallei, V. cholerae, and Y. pestis therapy based on CLSI M45-A2.
3. Use for NC53 and NC58 panels.
5. Based on EUCAST interpretive guidelines for Enterobacteriaceae, Acinetobacter spp., and S. maltophilia
all MICs of >2/38 will report as R, since these dilutions do not differentiate between I and R with
Enterobacteriaceae and Acinetobacter spp. (S≤2/38, I=4/76, R>4/76), and S and R with S. maltophilia
(S≤4/76, R>4/76).
9020-7493B Page 62 of 158

Trimethoprim- MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP. S. MALTOPHILIA

Sulfamethoxazole (T/S)
> R R R
4/76 I I S
2/38 S S S
2. Use for NM39 and NUC57panels.
Trimethoprim- MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP. S. MALTOPHILIA

> R R R
8/152 R R R
2/38 S S S
NOTE: 1. Therapies for y based on EUCAST V3.1.
4. Based on EUCAST interpretive guidelines for Enterobacteriaceae and Acinetobacter spp., all MICs of
> 2/38 will report as R, since these dilutions do not differentiate between I and R (S≤2/38, I=4/76,
R>4/76).
Trimethoprim- MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA V. CHOLERAE

> R R R
4/76 R R R
2/38 S S S
1/19 S S S
0.5/9.5 S S S

> R R
4/76 R R
2/38 S S
1/19 S S
0.5/9.5 S S
NOTE: 1. Enterobacteriaceae (except V. cholerae and Y. pestis) and Non-Enteroacteriaceae (except B.
pseudomallei) therapies based on CLSI M100-S22. B. pseudomallei, V. cholerae, and Y. pestis
Trimethoprim- MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA V. CHOLERAE

> R R R
2/38 S S S
0.5/9.5 S S S

> R R
2/38 S S
0.5/9.5 S S
pseudomallei) therapies based on CLSI M100-S22. B. pseudomallei, V. cholerae and Y. pestis
9020-7493B Page 63 of 158

DRIED OVERNIGHT GRAM-POSITIVE PANELS
Amikacin (Ak) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
32 R
16 I
8 S
3. Do not report drug, therapy or MIC for beta-hemolytic streptococci (S. agalactiae).
4. Do not report therapy for enterococci because dangerously misleading results can occur.
Amikacin (Ak) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
32 I
16 S
8 S
2. Do not report drug, therapy or MIC for beta-hemolytic streptococci (S. agalactiae).
Amoxicillin- MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

K Clavulanate (Aug)
> R
8/4 R
4/2 S
2/1 S
1/0.5 S
0.5/0.25 S
NOTE: 1. Enterococci and streptococci therapy based on EUCAST V3.1, see notes 7 and 8.
2. Staphylococci therapy based on CLSI M100-S22.
4. For S. aureus and S. lugdunensis, if Oxacillin is >2 or Cefoxitin Screen (CfxS) is >4, report Amoxicillin-K
Clavulanate as resistant regardless of MIC.
5. For panels containing only Oxacillin with coagulase-negative staphylococci (CNS) other than S.
lugdunensis, if Oxacillin MIC is ≥0.5, report Amoxicillin-K Clavulanate as resistant regardless of MIC.
6. For panels containing Cefoxitin Screen and Oxacillin with coagulase-negative staphylococci (CNS)
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Amoxicillin-K Clavulanate as
resistant regardless of MIC. For additional information refer to “Cefoxitin Screen” section in the front of
the guide.
7. Do not report therapy for enterococci, refer to Ampicillin result.
8. For streptococci, refer to Penicillin result.
9020-7493B Page 64 of 158

Amoxicillin- MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

K Clavulanate (Aug)
> R
16/8 R
8/4 R
4/2 S
2/1 S
2. For S. aureus and S. lugdunensis, if Oxacillin is >2 or Cefoxitin Screen (CfxS) is >4, report Amoxicillin-K
Clavulanate as resistant regardless of MIC.
3. For panels containing only Oxacillin with coagulase-negative staphylococci (CNS) other than S.
lugdunensis, if Oxacillin MIC is ≥0.5, report Amoxicillin-K Clavulanate as resistant regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Amoxicillin-K Clavulanate as
the guide.
5. For streptococci and beta-lactamase negative enterococci, refer to Penicillin result.
Ampicillin MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS L. monocytogenes

STREPTOCOCCI STREPTOCOCCI
(Am)
(S. agalactiae) (S. bovis group)
> R R - R -
8 R I - R -
4 R S - I -
0.25 S S S S S
NOTE: 1. Enterococci therapy based on EUCAST V3.1.
2. Staphylococci, beta-hemolytic streptococci and viridans streptococci therapies based on CLSI M100-
S22. L. monocytogenes therapies based on CLSI M45-A2.
3. Use for PC42E and PM33E panels.
4. Do not report drug, therapy or MIC for all streptococci except for beta-hemolytic streptococci (S.
agalactiae) and viridans streptococci (S. bovis group).
5. For staphylococci, if Penicillin MIC is >0.12, report Ampicillin as resistant regardless of MIC.
6. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Ampicillin as
resistant regardless of MIC.
7. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Ampicillin as resistant regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Ampicillin as resistant
regardless of MIC. For additional information refer to “Cefoxitin Screen” section in the front of the
therapy guide.
9. The CLSI interpretative guideline for Ampicillin with beta-hemolytic streptococci is ≤0.25 for susceptible.
Because intermediate and resistant interpretations have not been defined for beta-hemolytic
streptococci, no interpretations will be provided if the result is >0.25.
10. The CLSI interpretative guideline for Ampicillin with L. monocytogenes is ≤2 for susceptible. Because
intermediate and resistant interpretations have not been defined for L. monocytogenes, no interpretations
will be provided if the result is >0.25.
9020-7493B Page 65 of 158


(Am)
> R R N/R R -
8 R I N/R R -
4 R S N/R I -
2 R S N/R I S
1 R S N/R I S
0.5 N/R S N/R N/R S
3. Use for PM32 panel.
therapy guide.
streptococci, all MICs of ≥0.5 will report as N/R, since these dilutions do not differentiate between S and
NS.
will be provided if the result is >2.
11. Based on CLSI interpretive guidelines for staphylococci, all MICs of ≤0.5 will report as N/R, since
these dilutions do not differentiate between S and R (S≤0.25, R≥0.5).
12. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of ≤0.5 will report as N/R, since
these dilutions do not differentiate between S and I (S≤0.25, I=0.5-4, R≥8).
9020-7493B Page 66 of 158


(Am)
> R R N/R R -
8 R I N/R R -
4 R S N/R I -
2 R S N/R I S
1 N/R S N/R N/R S
3. Use for PC35 and PC38 panels.
therapy guide.
streptococci, all MICs of ≥1 will report as N/R, since these dilutions do not differentiate between S and
NS.
intermediate and resistant interpretations have not been defined for L. monocytogenes, no
interpretations will be provided if the result is >2.
11. Based on CLSI interpretive guidelines for staphylococci, all MICs of ≤1 will report as N/R, since these
dilutions do not differentiate between S and R (S≤0.25, R≥0.5).
12. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of ≤1 will report as N/R, since
9020-7493B Page 67 of 158


(Am)
> R R N/R R -
8 R I N/R R -
4 R S N/R I -
2 N/R S N/R N/R S
3. Use for PBC33 panel.
therapy guide.
NS.
9020-7493B Page 68 of 158


(Am)
> R R N/R R N/R
8 R I N/R R N/R
4 N/R S N/R N/R N/R
8. For panels containing Cefoxitin Screen and Oxacillin with coagulase-negative staphylococci (CNS) other
than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Ampicillin as resistant regardless of
MIC. For additional information refer to “Cefoxitin Screen” section in the front of the guide.
NS.
intermediate and resistant interpretations have not been defined for L. monocytogenes, all MICs of ≥4
will report as N/R, since these dilutions do not differentiate between S and NS.

(Am)
> R
8 I
4 S
2 S
1 S
0.5 S
0.25 S
0.12 S
3. Do not report therapy for L. monocytogenes.
4. Do not report drug, therapy or MIC for all streptococci (including viridans streptococci (S. bovis group))
except for beta-hemolytic streptococci (S. agalactiae).
guide.
9. For staphylococci, refer to the Cefoxitin Screen and/or Oxacillin result.
9020-7493B Page 69 of 158


(Am)
> R R - R -
8 R S - R -
4 R S - I -
2 R S - I S
1 R S - I S
0.5 R S - I S
0.25 S S S S S
NOTE: 1. Staphylococci, Enterococci beta-hemolytic streptococci and viridans streptococci therapies based on
CLSI M100-S22. L. monocytogenes therapies based on CLSI M45-A2.
4. Do not report drug, therapy or MIC for all streptococci, except for beta-hemolytic streptococci (S.
5. For streptococci refer to Penicillin result.
7. If beta-lactamase positive for staphylococci or enterococci, report Ampicillin as Blac regardless of MIC.
Because intermediate and resistant interpretations have not been defined for beta-hemolytic streptococci, no
interpretations will be provided if the result is >0.25.

(Am)
> R R - N/R -
8 R S - N/R -
0.25 S S S S S
interpretations will be provided if the result is >0.25
will be provided if the result is >0.25.
11. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of >0.25 will report as N/R,
since these dilutions do not differentiate between I and R (S≤0.25, I=0.5-4, R≥8).
9020-7493B Page 70 of 158

(Am)
> R R N/R R -
8 R S N/R R -
4 R S N/R I -
2 N/R S N/R N/R S
2. Use for PC29, PC33, PC34, PC40, PC41, PM26 and PM29 panels.
guide.
NS.
dilutions do not differentiate between S and R (S ≤0.25, R≥0.5).
13. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of ≤2, will report as N/R, since
9020-7493B Page 71 of 158


(Am)
> R R N/R R -
8 R S N/R R -
4 R S N/R I -
2 R S N/R I S
1 N/R S N/R N/R S
CLSI M100-S22. L. monocytogenes therapy based on CLSI M45-A2.
2. Use for PC32 panel.
guide.
NS.
12. Based on CLSI interpretive guidelines for staphylococci, all MICs of ≤1, will report as N/R, since these
dilutions do not differentiate between S and R (S ≤0.25, R≥0.5).
13. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of ≤1, will report as N/R, since
Amp-Sulbactam (A/S) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
16/8 I
8/4 S
2. For S. aureus and S. lugdunensis, if oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report
Ampicillin-Sulbactam as resistant regardless of MIC.
3. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Ampicillin-Sulbactam as resistant
regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Ampicillin-Sulbactam as
the guide.
5. For streptococci and beta-lactamase negative enterococci, refer to Penicillin result.
9020-7493B Page 72 of 158

Arbekacin (Abk) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI L. monocytogenes

(S. aureus)
> R
8 I
4 S
NOTE: 1. Therapy based on guidelines other than CLSI and EUCAST.
2. Do not report drug, therapy or MIC for enterococci, streptococci and L. monocytogenes.
Azithromycin (Azi) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI L. monocytogenes
> R
2 I
1 S
4. Do not report drug, therapy or MIC for enterococci, streptococci or L. monocytogenes.
Azithromycin (Azi) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI L. monocytogenes
> R
4 I
2 S
1 S
0.5 S
Cefazolin (Cfz) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI L. monocytogenes
> R
16 I
8 S
4 S
2 S
2. Do not report therapy for enterococci and L. monocytogenes because dangerously misleading results
can occur.
3. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report
Cefazolin as resistant regardless of MIC.
4. For CNS other than S. lugdunensis, if Oxacillin is ≥0.5, report Cefazolin as resistant regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefazolin as resistant
guide.
9020-7493B Page 73 of 158

Cefdinir (Cdn) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI L. monocytogenes
> R
2 I
1 S
can occur.
Cefdinir as resistant regardless of MIC.
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefdinir as resistant regardless of
MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefdinir as resistant
therapy guide.
Cefepime (Cpe) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R N/R R
16 I N/R R
8 S N/R R
4 S N/R N/R
can occur.
3. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Cefepime
as resistant regardless of MIC.
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefepime as resistant regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefepime as resistant
guide.
7. The CLSI interpretative guideline for Cefepime with beta-hemolytic streptococci is ≤0.5 for susceptible.
NS.
8. Based on CLSI interpretive guidelines for viridans streptococci, all MICs ≤4 will report as N/R, since these
dilutions do not differentiate between S, I and R (S ≤1, I=2, R≥4).
9020-7493B Page 74 of 158

Cefepime (Cpe) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> N/R N/R R
8 S N/R R
4 S N/R N/R
can occur.
3. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Cefepime
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefepime as resistant regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefepime as resistant
guide.
7. Based on CLSI interpretive guidelines for staphylococci, all MICs >8 will report as N/R, since these dilutions
do not differentiate between I and R (S ≤8, I=16, R≥32).
NS.
9. Based on CLSI interpretive guidelines for viridans streptococci, all MICs ≤4 will report as N/R, since these
dilutions do not differentiate between S, I and R (S ≤1, I=2, R≥4).
Cefotaxime (Cft) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> N/R N/R R
2 S N/R I
1 S N/R S
2. Staphylococci and beta-hemolytic and viridans streptococci therapies based on CLSI M100-S22.
can occur.
Cefotaxime as resistant regardless of MIC.
6. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefotaxime as resistant
regardless of MIC.
than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefotaxime as resistant regardless of
8. Based on CLSI interpretive guidelines for staphylococci, all MICs of >2 will report as N/R, since these
dilutions do not differentiate between S, I and R (S ≤8, I=16-32, R ≥64).
9. The CLSI interpretative guideline for Cefotaxime with beta-hemolytic streptococci is ≤0.5 for susceptible.
NS.
9020-7493B Page 75 of 158


>
16
0.5
can occur.
4. For staphylococci, refer to Cefoxitin Screen and/or Oxacillin result.
Cefotaxime as resistant regardless of MIC.
6. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefotaxime as resistant
regardless of MIC.
8. Do not report drug, therapy or MIC for all streptococci (including viridans streptococci (S. bovis group))
except for beta-hemolytic streptococci (S. agalactiae).
9. For beta-hemolytic streptococci (S. agalactiae), refer to Penicillin result.

> R - N/R
32 I - N/R
16 I - N/R
8 S - N/R
1 S - S
0.5 S S S
2. Do not report therapy for enterococci and L. monocytogenes because dangerously misleading results can
occur.
3. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Cefotaxime as
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefotaxime as resistant regardless of MIC.
5. For panels containing Cefoxitin Screen and Oxacillin with coagulase-negative staphylococci (CNS) other than
S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefotaxime as resistant regardless of MIC. For
additional information refer to “Cefoxitin Screen” section in the front of therapy guide.
6. Do not report drug, therapy or MIC for all streptococci except for beta-hemolytic streptococci (S. agalactiae)
and viridans streptococci (S. bovis group).
8. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of >1 will report as N/R, since these
dilutions do not differentiate between S, I and R (S ≤1, I=2, R ≥4).
9020-7493B Page 76 of 158


> R N/R R
32 I N/R R
8 S N/R N/R
2. Use for panels with breakpoint format.
occur.
4. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Cefotaxime
5. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefotaxime as resistant regardless of
MIC.
NS.
these dilutions do not differentiate between S, I and R (S ≤1, I=2, R ≥4).
Ceftaroline (Cpt) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

(S. aureus) STREPTOCOCCI STREPTOCOCCI
> R
1 S
0.5 S
3. Do not report drug, MIC or therapy for enterococci, L. monocytogenes and streptococci.
4. Do not report therapy for coagulase negative staphylococci.
9020-7493B Page 77 of 158

Ceftriaxone (Cax) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R N/R R
32 I N/R R
16 I N/R R
8 S N/R R
4 S N/R N/R
can occur.
Ceftriaxone as resistant regardless of MIC.
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Ceftriaxone as resistant regardless of
MIC.
S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Ceftriaxone as resistant regardless of MIC.
For additional information refer to “Cefoxitin Screen” section in the front of the guide.
7. The CLSI interpretative guideline for Ceftriaxone with beta-hemolytic streptococci is ≤0.5 for
susceptible. Because intermediate and resistant interpretations have not been defined for beta-
hemolytic streptococci, all MICs of ≥4 will report as N/R, since these dilutions do not differentiate
between S and NS.
8. Based on CLSI interpretive guidelines for viridans streptococci, MICs of ≤4 will report as N/R, since these
dilutions do not differentiate between I and R (S ≤1, I =2, R≥4).
Ceftriaxone (Cax) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R N/R R
32 I N/R R
16 I N/R R
8 S N/R N/R
can occur.
Ceftriaxone as resistant regardless of MIC.
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Ceftriaxone as resistant regardless of
MIC.
S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Ceftriaxone as resistant regardless of MIC. For
additional information refer to “Cefoxitin Screen” section in the front of the guide.
7. The CLSI interpretative guideline for Ceftriaxone with beta-hemolytic streptococci is ≤0.5 for
susceptible. Because intermediate and resistant interpretations have not been defined for beta-
hemolytic streptococci, all MICs of ≥8 will report as N/R, since these dilutions do not differentiate
between S and NS.
8. Based on CLSI interpretive guidelines for viridans streptococci, MICs of ≤8 will report as N/R, since these
9020-7493B Page 78 of 158

Cefuroxime sodium (Crm) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI L. monocytogenes

(parenteral)
> R
16 I
8 S
4 S
can occur.
Cefuroxime sodium as resistant regardless of MIC.
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefuroxime sodium as resistant
regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefuroxime sodium as
the guide.
Cefuroxime sodium (Crm) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

(parenteral)
> N/R
8 S
4 S
can occur.
Cefuroxime sodium as resistant regardless of MIC.
5. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cefuroxime sodium as resistant
regardless of MIC.
S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cefuroxime sodium as resistant regardless of MIC.
Cephalothin (Cf) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
16 I
8 S
occur.
3. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Cephalothin as
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Cephalothin as resistant regardless of MIC.
S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Cephalothin as resistant regardless of MIC. For
additional information refer to “Cefoxitin Screen” section in the front of the therapy guide.
9020-7493B Page 79 of 158

Chloramphenicol (C) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
16 I I R
8 S S I
4 S S S
ChIoramphenicol (C) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
16 I I R
8 S S N/R
4. Based on CLSI interpretive guidelines for streptococci, all MICs of ≤8 will report as N/R, since these
Chloramphenicol (C) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> N/R R
8 S N/R
3. Use for PBC33 and PM32 panels.
5. Do not report drug, therapy or MIC for staphylococci.
6. Based on CLSI interpretive guidelines for enterococci, all MICs of >8 will report as N/R, since these
Ciprofloxacin (Cp) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
2 R I
1 S S
0.5 S S
NOTE: 1. Staphylococci therapy based on EUCAST V3.1.
2. Enterococci therapy based on CLSI M100-S22.
3. Use for EUCAST Blended panel class, except for PBC33 and PM32 panels.
9020-7493B Page 80 of 158

> R R
1 S S
0.5 S S
4. Based on CLSI interpretive guidelines for enterococci, all MICs of >1 will report as R, since these
> R R
2 I I
1 S S
0.5 S S
Clarithromycin (Cla) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
2 I
1 S
4. Do not report drug, therapy or MIC for enterococci, L. monocytogenes or streptococci.
Clarithromycin (Cla) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
4 I
2 S
Clindamycin (Cd) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
2 R R
1 R R
0.5 I I
0.25 S S
2. Streptococci therapy based on CLSI M100-S22.
7. For staphylococci, if Inducible Clindamycin (ICd) test is positive (>4/0.5) report Clindamycin as
9020-7493B Page 81 of 158

> R
2 R
1 R
0.5 I
0.25 S
5. Do not report drug, therapy or MIC for all streptococci, including beta-hemolytic streptococci (S.
> R R
4 R R
2 I R
1 I R
0.5 S I
0.25 S S
> R R
4 R R
2 I R
1 I R
0.5 S N/R
5. Based on CLSI interpretive guidelines for streptococci, all MICs of ≤0.5 will report as N/R, since these
dilutions do not differentiate between S and I (S≤0.25, I=0.5, R≥1).
9020-7493B Page 82 of 158

Daptomycin (Dap) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R - R -
4 R S R -
2 R S R -
1 S S S S
0.5 S S S S
0.25 S S S S
NOTE: 1. Staphylococci and beta-hemolytic streptococci therapies based on EUCAST V3.1.
2. Enterococci and viridans streptococci therapies based on CLSI M100-S22.
agalactiae) and S. bovis group (Group D).
5. The CLSI interpretative guideline for Daptomycin with enterococci is ≤4 for susceptible. Because intermediate
and resistant interpretations have not been defined for enterococci, no interpretations will be provided if the
result is >4.
6. The CLSI interpretative guideline for Daptomycin with viridans streptococci is ≤1 for susceptible. Because
intermediate and resistant interpretations have not been defined for viridans streptococci, no interpretations will
be provided if the result is >1.
Daptomycin (Dap) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R
4 R R
2 R R
1 S S
Daptomycin (Dap) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> - - -
4 - S -
2 - S -
1 S S S
0.5 S S S
0.25 S S S
3. The CLSI interpretative guideline for Daptomycin with staphylococci and streptococci is ≤1 for
susceptible. Because intermediate and resistant interpretations have not been defined for
staphylococci and streptococci, no interpretations will be provided if the result is >1.
4. The CLSI interpretative guideline for Daptomycin with enterococci is ≤4 for susceptible. Because
intermediate and resistant interpretations have not been defined for enterococci, no interpretations will
9020-7493B Page 83 of 158

Ertapenem (Etp) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R -
1 S S
0.5 S S
2. Staphylococci and beta-hemolytic streptococci therapies based on CLSI M100-S22.
4. Do not report drug, therapy or MIC for Listeria monocytogenes and all Coagulase-Negative
Staphylococci (CNS) with MIC >0.5 for Ox or CfxS >4, including S. lugdunensis with an MIC >2 for
Oxacillin.
5. For S. aureus, if Oxacillin MIC is >2 and\or CfxS is >4, report Ertapenem as resistant regardless of
MIC.
7. Do not report therapy for viridans streptococci (S. bovis group).
8. The CLSI interpretative guideline for Ertapenem with beta-hemolytic streptococci is ≤1 for susceptible.
streptococci, no interpretations will be provided if the result is >1.
9. Based on CLSI interpretive guidelines for staphylococci, all MICs of >1 will report as R, since these

> R -
4 I -
2 S -
1 S S
0.5 S S
Oxacillin.
3. For S. aureus, if Oxacillin MIC is >2 and\or CfxS is >4, report Ertapenem as resistant regardless of MIC.
streptococci, no interpretations will be provided if the result is >1.
9020-7493B Page 84 of 158


> R N/R
4 I N/R
2 S N/R
Oxacillin.
3. For S. aureus, if Oxacillin MIC is >2 and\or CfxS is >4, report Ertapenem as resistant regardless of MIC.
streptococci, all MICs of ≥2will report as N/R, since these dilutions do not differentiate between S and
NS.
Erythromycin (E) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R R
4 R I R
2 I I R
1 S I R
0.5 S S I
0.25 S S S
3. Use for EUCAST Blended panel class, except for PBC32, PBC33, PC35, PC37, PC42E, PM32 and
PM33E panels.
5. Do not report drug, therapy or MIC for L. monocytogenes.

> R R R
4 R I R
2 I I R
1 S I R
0.5 S S N/R
3. Use for PC37, PC42E and PM33E panels.
8. Based on EUCAST interpretive guidelines for beta-hemolytic streptococci, all MICs of ≤0.5 will report
as N/R, since these dilutions do not differentiate between S and I (S≤0.25, I=0.5, R>0.5).
9020-7493B Page 85 of 158


> R R R
2 I I R
1 S I R
0.5 S S N/R
dilutions do not differentiate between I and R (S≤0.5, I=1-4, R≥8).
9. Based on EUCAST interpretive guidelines for beta-hemolytic streptococci, all MICs of ≤0.5 will report
as N/R, since these dilutions do not differentiate between S and I (S≤0.25, I=0.5, R>0.5).

> R R R
2 I I R
1 S N/R N/R
2. Enterococci therapy based on CLSI M100-S22
3. Use for PBC32, PBC33 and PM32 panels.
8. Based on CLSI interpretive guidelines for enterococci, all MICs of ≤1 will report as N/R, since these
dilutions do not differentiate between S, I and R (S≤0.5, I=1-4, R≥8).
9. Based on EUCAST interpretive guidelines for beta-hemolytic streptococci, all MICs of ≤1 will report as
N/R, since these dilutions do not differentiate between S, I and R (S≤0.25, I=0.5, R>0.5).

> R R
4 R R
2 I R
1 S R
0.5 S I
0.25 S S
2. Use for PC36 and PM31 panels.
3. Only systemic therapy will be reported
9020-7493B Page 86 of 158


> R R
8 R R
4 R R
2 I R
1 S N/R
7. Based on EUCAST interpretive guidelines for beta-hemolytic streptococci, all MICs of ≤1 will report as
N/R, since these dilutions do not differentiate between S and I (S≤0.25, I=0.5, R>0.5).

> R R R
4 I I R
2 I I R
1 I I R
0.5 S S I
0.25 S S S
3. Use for PBC27, PC32, PM21, PM26 and PM29 panels.

> R R R
4 I I R
2 I I R
1 I I R
0.5 S S N/R
3. Use for PBC28, PC20, PC21, PC29, PC31, PC33, PC34, PC39, PC40, PC41, PC42C, PM28 and
PM33C panels.
7. Based on CLSI interpretive guidelines for beta-hemolytic streptococci, all MICs of ≤0.5 will report as
N/R, since these dilutions do not differentiate between S and I (S≤0.25, I=0.5, R≥1).
9020-7493B Page 87 of 158


> R R R
4 I I R
0.5 S S I
0.25 S S S
NOTE: 1. Therapy based on CLSI M100-S22
3. Use for PC1A panel.

> R R R
4 I I R
0.5 S S N/R
3. Use for PBC20, PBC23 and PBC29 panels.
7. Based on CLSI interpretive guidelines for beta-hemolytic streptococci, all MICs of ≤0.5 will report as
N/R, since these dilutions do not differentiate between S and I (S≤0.25, I=0.5, R≥1).
Fosfomycin (Fos) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
64 R
32 S
Fusidic Acid (FA) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
16 I
2 S
Fusidic Acid (FA) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> N/R
2 S
2. Use for PBC33, PM31, PM32, PM33C and PM33E panel.
3. Based on SFM 2008 interpretive guidelines for staphylococci, all MICs of >2 will report as N/R, since
these dilutions do not differentiate between S, I and R (S≤2, I=4-16, R>16).
9020-7493B Page 88 of 158

Gatifloxacin (Gat) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

> R
4 I
2 S
1 S
0.5 S
Gentamicin (Gm) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

> R
8 R
4 R
2 R
1 S
4. Do not report drug, therapy or MIC for all streptococci
Gentamicin (Gm) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

> R
8 I
4 S
2 S
1 S
3. Do not report drug, therapy or MIC for for all streptococci.
Imipenem (Imp) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R
8 I I
4 S S
2 S S
NOTE: 1. Enterococci and beta-hemolytic streptococci therapies based on EUCAST V3.1.
4. For S. aureus and S. lugdunensis if Oxacillin MIC is >2 and/or Cefoxitin Screen >4, report Imipenem as
5. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Imipenem as resistant regardless of MIC.
S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Imipenem as resistant regardless of MIC. For
7. Do not report drug, therapy or MIC for E. faecium and E. faecium group.
10. For beta-hemolytic streptococci, refer to Penicillin result.
9020-7493B Page 89 of 158

Imipenem (Imp) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> N/R
2 S
1 S
3. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Imipenem
5. For panels containing Cefoxitin Screen and Oxacillin with coagulase-negative staphylococci (CNS) other than S.
lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Imipenem as resistant regardless of MIC. For
7. For staphylococci, refer to Cefoxitin Screen and/or the Oxacillin result.
10. For beta-hemolytic streptococci, refer to Penicillin result.
11. Based on EUCAST interpretive guidelines for enterococci, all MICs of >2 will report as N/R, since
these dilutions do not differentiate between S, I and R (S≤4, I=8, R>8).
Imipenem (Imp) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
8 I
4 S
2 S
1 S
2. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 or Cefoxitin Screen (CfxS) is >4, report Imipenem
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Imipenem as resistant
guide.
Kanamycin (K) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
16 I
8 S
4 S
2 S
2. Do not report drug, therapy or MIC for all streptococci (including beta-hemolytic streptococci (S.
agalactiae)), except viridans streptococci (S. bovis group).
9020-7493B Page 90 of 158

Levofloxacin (Lvx) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R R R
4 R I R I
2 I S I S
1 S S S S
3. Use for EUCAST Blended panel class, except for PBC33 and PM32 panels.

> R R R N/R
2 I S I S
1 S S S S
5. Based on CLSI interpretive guidelines for enterococci all MICs of >2 will report as R, since these
6. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of >2 will report as N/R, since

> R R
4 R R
2 I I
1 S S
0.5 S S
2. Use for the EUCAST panel class.
Levofloxacin (Lvx) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
4 R I I
2 I S S
1 S S S
0.5 S S S
NOTE: 1. Therapy based CLSI M100-S22.
9020-7493B Page 91 of 158

Levofloxacin (Lvx) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

> R R R
4 R I I
2 N/R S S
Lincomycin (Lin) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
8 I I I
4 I I I
2 S S S
1 S S S
Linezolid (Lzd) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R R -
4 S S I -
2 S S S S
1 S S S S
0.5 S S S S
NOTE: 1. Staphylococci, enterococci and beta-hemolytic streptococci therapies based on EUCAST V3.1.
2. Viridans streptococci therapy based on CLSI M100-S22.
5. The CLSI interpretative guideline for Linezolid with viridans streptococci is ≤2 for susceptible. Because
intermediate and resistant interpretations have not been defined for viridans streptococci, no
Linezolid (Lzd) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R R
4 S S I
2 S S S
1 S S S
0.5 S S S
9020-7493B Page 92 of 158

Linezolid (Lzd) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R -
4 S I -
2 S S S
1 S S S
0.5 S S S
3. The CLSI interpretative guidelines for Linezolid with streptococci is ≤2 for susceptible. Because
intermediate and resistant interpretations have not been defined for streptococci, no interpretations will
Meropenem (Mer) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R N/R
8 I N/R
4 S N/R
2 S N/R
2. Staphylococci and streptococci therapies based on CLSI M100-S22.
3. Use for EUCAST Blended panel class
Meropenem as resistant regardless of MIC.
6. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Meropenem as resistant regardless of
MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Meropenem as resistant
guide.
8. Do not report drug, therapy or MIC for L. monocytogenes, all streptococci, except beta-hemolytic
streptococci (S. agalactiae) and viridans streptococci (S. bovis group).
10. The CLSI interpretative guideline for Meropenem with beta-hemolytic and viridans streptococci is ≤0.5
for susceptible. Because intermediate and resistant interpretations have not been defined for
NS.
9020-7493B Page 93 of 158

Meropenem (Mer) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R N/R
8 I N/R
4 S N/R
2 S N/R
1 S N/R
Meropenem as resistant regardless of MIC.
4. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Meropenem as resistant regardless of MIC.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Meropenem as resistant
guide.
6. Do not report drug, therapy or MIC for L. monocytogenes
8. The CLSI interpretative guideline for Meropenem with beta-hemolytic and viridans streptococci is ≤0.5
for susceptible. Because intermediate and resistant interpretations have not been defined for
NS.
Minocycline (Min) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R
1 N/R
4. Do not report therapy for beta-hemolytic streptococci (S. agalactiae)
5. Based on EUCAST interpretive guidelines for staphylococci, all MICs of ≤1 will report as N/R since
these dilutions do not differentiate between S and I (S≤0.5, I=1, R>1).
Minocycline (Min) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R
8 I I
4 S S
2 S S
1 S S
2. Use for PM33C and PM33E.
4. Do not report therapy for beta-hemolytic streptococci (S. agalactiae).
9020-7493B Page 94 of 158

Moxifloxacin (Mxf) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R
2 R
1 I
0.5 S
2. Use for EUCAST Blended and EUCAST panel classes and PBC27, PBC28, PBC29, PM28, and PM33C
panels.
5. Do not report therapy for beta-hemolytic streptococci (S. agalactiae).
Moxifloxacin (Mxf) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
4 I
2 S
1 S
0.5 S
3. Use for PBC20, PBC23, PC29, PC33, PC34, PM26 and PM29 panels.
Moxifloxacin (Mxf) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
2 I I
1 I I
0.5 I S
0.12 S S
NOTE: 1. Therapy based on MENSURA.
Mupirocin (Mup) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
256 -
8 -
4 S
NOTE: 1. Therapy based on manufacturers’ guidelines.
2. Breakpoints for skin infection isolates are ≤4, susceptible; ≥8, resistant. Breakpoints for nasal colonizing
isolates are ≤256 susceptible, ≥512 resistant. The Mupirocin category interpretations differ if the MIC is 8 or
256 and an alert will trigger.
3. Do not report drug, therapy or MIC for S. saprophyticus.
9020-7493B Page 95 of 158

Mupirocin (Mup) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
256 S
NOTE: 1. Therapy based on manufacturers’ guidelines for nasal colonization isolates.
2. Use for PC42C, PC42E, PM33C and PM33E panels.
3. Based on manufacturers’ guidelines with susceptible ≤4 and resistant ≥8, panel dilutions do not allow
reporting for skin infection isolates.
Netilmicin (Nt) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> N/R
4 S
2 S
NOTE: 1. Enterococci and streptococci therapies based on EUCAST V3.1.
occur.
Netilmicin (Nt) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
16 I
8 S
4 S
occur.
Nitrofurantoin (Fd) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R
64 S S
32 S S
Nitrofurantoin (Fd) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
64 I I
32 S S
9020-7493B Page 96 of 158

Norfloxacin (Nxn) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
8 I I
4 S S
Ofloxacin (Ofl) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R
4 R
2 R
1 S
0.5 S
Ofloxacin (Ofl) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R
4 I I
2 S S
NOTE: 1. Therapy based on CLSI (NCCLS) M100-S14.
Oxacillin (Ox) MIC S. AUREUS & OTHER ENTEROCOCCI STREPTOCOCCI

S. LUGDUNENSIS STAPHYLOCOCCI
> R R
2 S R
1 S R
0.5 S R/S*
0.25 S S
3. For panels containing the Cefoxitin Screen, all staphylococci report Oxacillin as resistant if the
Cefoxitin Screen is >4. See Cefoxitin Screen information in the front of the therapy guide.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Oxacillin as resistant
therapy guide.
other than S. lugdunensis, if CfxS is <4 and Oxacillin MIC is 0.5, report Oxacillin as susceptible (S*).
For additional information refer to “Cefoxitin Screen” section in the front of the therapy guide.
9020-7493B Page 97 of 158

Oxacillin (Ox) MIC S. AUREUS & OTHER ENTEROCOCCI STREPTOCOCCI

> R R
4 R R
2 S R
1 S R
0.5 S R/ S*
0.25 S S
2. For panels containing the Cefoxitin Screen, all staphylococci report Oxacillin as resistant if the
Cefoxitin Screen is >4. See Cefoxitin Screen information in the front of the guide.
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Oxacillin as resistant
therapy guide.
other than S. lugdunensis, if CfxS is <4 and Oxacillin MIC is 0.5, report Oxacillin as susceptible (S*).
Penicillin (P) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS L. monocytogenes

> R R - R -
8 R S - R -
2 R S - I S
0.25 R S - I S
0.12 S S S S S
0.03 S S S S S
2. Enterococci, beta-hemolytic streptococci and viridans streptococci therapies based on CLSI M100-S22.
L. monocytogenes therapies based on CLSI M45-A2
Penicillin as resistant regardless of MIC.
5. For CNS other than S. lugdunensis, if Oxacillin MIC is >0.25 and/or Cefoxitin Screen >4, report
6. The CLSI interpretative guideline for Penicillin with beta-hemolytic streptococci is ≤0.12 for susceptible.
7. The CLSI interpretative guideline for Penicillin with L. monocytogenes is ≤2 for susceptible. Because
8. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of >2 will report as R, since
these dilutions do not differentiate between I and R (S≤0.12, I=0.25-2, R≥4).
9020-7493B Page 98 of 158


> R R - R -
2 R S - I S
0.25 R S - I S
0.12 S S S S S
0.06 S S S S S
0.03 S S S S S
2. Enterococci, bta-hemolytic streptococci and viridans streptococci therapies based on CLSI M100-S22.
L. monocytogenes therapies based on CLSI M45-A2
3. Use for PBC33, PC35 and PM32 panels.
dilutions do not differentiate between S and R (S≤8, R≥16).

> R R - N/R -
8 R S - N/R -
0.12 S S S S S
0.06 S S S S S
0.03 S S S S S
L. monocytogenes therapies based on CLSI M45-A2.
9020-7493B Page 99 of 158


> R R - R -
8 R S - R -
0.25 R S - I S
0.12 S S S S S
3. Use for PM33E panel.
8. Based on CLSI interpretive guidelines for viridans streptococci, all MICs of >0.25 will report as R, since

> R R - N/R -
0.25 R S - I S
0.12 S S S S S
0.03 S S S S S
3. Use for PC37 and PC42E panels.
9. Based on CLSI interpretive guidelines for enterococci, all MICs of >0.25 will report as R, since these
9020-7493B Page 100 of 158


> R
16 R
1 R
0.5 R
0.25 N/R
3. Do not report drug, therapy or MIC for all streptococci.
5. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 and/or Cefoxitin Screen >4, report Penicillin as
other than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Penicillin as resistant
guide.
8. Based on EUCAST interpretive guidelines for staphylococci, all MICs of ≤0.25 will report as N/R, since
these dilutions do not differentiate between S and R (S≤0.12, R>0.25).

> R
2 R
0.25 R
0.12 S
0.06 S
0.03 S
3. Do not report drug, therapy or MIC for all streptococci.
4. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2 and/or Cefoxitin Screen >4, report Penicillin as
guide.
9020-7493B Page 101 of 158


> R R - R -
8 R S - R -
4 R S - R -
2 R S - I S
1 R S - I S
0.5 R S - I S
0.25 R S - I S
0.12 S S S S S
0.06 S S S S S
0.03 S S S S S
NOTE: 1. Staphylococci, Enterococci, beta-hemolytic streptococci, and viridans streptococci therapy based on
CLSI M100-S22. L. monocytogenes therapies based on CLSI M45-A2
3. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Penicillin as resistant regardless of MIC.
therapy guide.
5. If beta-lactamase positive, report Penicillin as Blac regardless of MIC.
6. For enterococci, if beta-lactamase positive, report Penicillin as Blac regardless of MIC.
Because intermediate and resistant interpretations have not been defined for beta-hemolytic streptococci,
no interpretations will be provided if the result is >0.12.
intermediate and resistant interpretations have not been defined for L. monocytogenes, no interpretations will
9020-7493B Page 102 of 158


> R R - N/R -
8 R S - N/R -
0.12 S S S S S
0.06 S S S S S
0.03 S S S S S
3. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Penicillin as resistant regardless of
MIC.
therapy guide.

> R R - R -
8 R S - R -
2 R S - I S
0.25 R S - I S
0.12 S S S S S
0.06 S S S S S
0.03 S S S S S
therapy guide.
9020-7493B Page 103 of 158

> R R - N/R -
0.25 R S - I S
0.12 S S S S S
0.03 S S S S S
therapy guide.
be provided if the result is >0.25.
10. Based on CLSI interpretive guidelines for enterococci, all MICs of >0.25 will report as R, since these
Piperacillin-Tazobactam MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

(P/T)
> R
8 S
4 S
2 S
1 S
2. Do not report drug, therapy or MIC, for CNS with an MIC ≥0.5 for oxacillin or CfxS >4.
3. Do not report drug, therapy or MIC, for S. aureus and S. lugdunensis with an MIC >2 for Oxacillin or
CfxS >4.
4. For non-beta-lactamase producing enterococci, refer to Penicillin result.
Pristinamycin (Prs) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
2 I I I
1 S S S
0.5 S S S
9020-7493B Page 104 of 158

Rifampin (Rif) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
16 I I
8 I I
4 I S
1 I S
0.5 S S
Rifampin (Rif) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
2 I I
1 S S
0.5 S S
Synercid (Syn) MIC STAPHYLOCOCCI E. faecium ENTEROCOCCI BETA-HEMOLYTIC

(other than E. faecium) STREPTOCOCCI
(Quinupristin/Dalfopristin)
(S. agalactiae)
> R R R R
4 R I R R
2 I I I I
1 S S S S
NOTE: 1. Staphylococci and E. faecium therapies based on EUCAST V3.1.
2. Enterococci (except E. faecium) and streptococci therapies based on CLSI M100-S22.
4. It is important to speciate strains of enterococci, since Synercid is not active against E. faecalis.
Synercid (Syn) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

(E. faecium only)
> R R
4 R I
2 I I
1 S S
0.5 S S
2. Use for EUCAST panel class, except for PC30 panel.
9020-7493B Page 105 of 158

Synercid (Syn) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

(E. faecium only)
> R R
2 I I
1 S S
0.5 S S
0.25 S S
4. Based on EUCAST interpretive guidelines for E. faecium, all MICs of >2 will report as R, since these
dilutions do not differentiate between I and R (S≤1, I=2-4, R>4).
Synercid (Syn) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R R
4 R R R
2 I I I
1 S S S
0.5 S S S
0.25 S S S
Teicoplanin (Tei) MIC S. AUREUS STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
8 R S R
4 R S R
2 S S S
1 S S S
NOTE: 1. S. aureus and enterococci therapies based on EUCAST V3.1.
2. Staphylococci (except S. aureus) therapy based on CLSI M100-S22.
3. Use for EUCAST Blended panel class, except for PC42E and PM33E panels.
4. Do not report drug, therapy or MIC for S. haemolyticus.
5. Based on CLSI interpretive guidelines for staphylococci (except S. aureus), all MICs of >8 will report
as R, since these dilutions do not differentiate between I and R (S≤8, I=16, R≥32).
Teicoplanin (Tei) MIC S. AUREUS STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
16 R I R
8 R S R
4 R S R
2 S S S
1 S S S
NOTE: 1. S. aureus and enterococci therapies based on EUCAST V3.1.
2. Staphylococci (except S. aureus) therapy based on CLSI M100-S22.
3. Use for PC42E and PM33E panels.
9020-7493B Page 106 of 158

Teicoplanin (Tei) MIC S. AUREUS COAGULASE ENTEROCOCCI STREPTOCOCCI

NEGATIVE
STAPHYLOCOCCI
> R R
8 R R
4 R R
2 S S
1 S S
3. Do not report drug, therapy or MIC for all coagulase negative staphylococci (CNS).
Teicoplanin (Tei) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R
16 I I
8 S S
4 S S
2 S S
1 S S
Tetracycline (Te) MIC STAPHYLOCOCCI ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

> R R R N/R
2 I S I S
1 S S S S
NOTE: 1. Staphylococci and beta-hemolytic streptococci (S. agalactiae) therapies based on EUCAST V3.1.
3. Use for EUCAST Blended panel class, except for PC38, PC42E and PM33E panels.
5. Based on CLSI interpretive guidelines for enterococci all MICs of >2 will report as R, since these
dilutions do not differentiate S, I and R (S≤4, I=8, R≥16).
6. Based on CLSI interpretive guidelines for viridans streptococci all MICs of >2 will report as N/R, since
these dilutions do not differentiate I and R (S≤2, I=4, R≥8).

> R R R R
8 R I R R
4 R S R I
2 I S I S
1 S S S S
NOTE: 1. Staphylococci and beta-hemolytic streptococci (S. agalactiae) therapies based on EUCAST V3.1.
3. Use for PC38, PC42E and PM33E panels.
9020-7493B Page 107 of 158


> R R
8 R R
4 N/R N/R
4. Based on EUCAST interpretive guidelines for staphylococci and beta-hemolytic streptococci, all MICs of
≤4 will report as N/R, since these dilutions do not differentiate between S, I and R (S≤1, I=2, R>2).

> R R
8 R R
4 R R
2 I I
1 S S
Tetracycline (Te) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
8 I I R
4 S S I
2 S S S
1 S S S
Tetracycline (Te) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R R R
8 I I R
4 S S N/R
9020-7493B Page 108 of 158

Ticarcillin - K Clavulanate MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

(Tim)
> R
8 S
Ticarcillin-K Clavulanate as resistant regardless of MIC.
3. For CNS other than S. lugdunensis, if Oxacillin MIC is ≥0.5, report Ticarcillin-K Clavulanate as resistant
regardless of MIC.
than S. lugdunensis, if CfxS is >4 and/or Oxacillin MIC is ≥1, report Ticarcillin-K Clavulanate as resistant
regardless of MIC. For additional information refer to “Cefoxitin Screen” section in the front of the guide.
Tobramycin (To) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
8 R
4 R
2 R
1 S
3. Do not report drug, therapy or MIC for beta-hemolytic streptococci. See notes for species names.
Tobramycin (To) MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI
> R
8 I
4 S
2 S
1 S
2. Do not report drug, therapy or MIC for beta-hemolytic streptococci. See notes for species names.
Trimethoprim- MIC STAPHYLOCOCCI ENTEROCOCCI STREPTOCOCCI

> R
8/152 R
4/76 I
2/38 S
1/19 S
2. Use for EUCAST Blended and EUCAST panel classes, except for PC30 and PC36 panels
4. If TFG negative, report therapy as TFG for all gram-positive organisms.
5. Do not report therapy for enterococci.
9020-7493B Page 109 of 158


> R
8/152 R
2/38 S
7. Based on EUCAST interpretive guidelines for staphylococci, all MICs of >2/38 will report as R, since
these dilutions do not differentiate S, I and R (S≤2/38, I=4/76, R>4/76).

> R
2/38 S
1/19 S
7. Based on EUCAST interpretive guidelines for staphylococci, all MICs of >2/38 will report as R, since
these dilutions do not differentiate S, I and R (S≤2/38, I=4/76, R>4/76).

> R
8/152 R
4/76 R
2/38 S
1/19 S
0.5/9.5 S
0.06/1.14 S
9020-7493B Page 110 of 158

Vancomycin (Va) MIC STAPHYLOCOCCI COAGULASE- ENTEROCOCCI BETA-HEMOLYTIC VIRIDANS

(S. aureus) NEGATIVE STREPTOCOCCI STREPTOCOCCI
STAPHYLOCOCCI (S. agalactiae) (S. bovis group)
> R R R R R
16 R R R R R
8 R R R R R
4 R S S R R
2 S S S S S
1 S S S S S
0.5 S S S S S
0.25 S S S S S
Vancomycin (Va) MIC S. AUREUS COAGULASE- NEGATIVE ENTEROCOCCI STREPTOCOCCI

STAPHYLOCOCCI
> R R R -
16 R I I -
8 I I I -
4 I S S -
2 S S S -
1 S S S S
0.5 S S S S
0.25 S S S S
3. The CLSI interpretative guideline for Vancomycin with streptococci is ≤1 for susceptible. Because
intermediate and resistant interpretations have not been defined for streptococci, no interpretations will be
provided if the result is >1.
Vancomycin (Va) MIC S. AUREUS COAGULASE- NEGATIVE ENTEROCOCCI STREPTOCOCCI

STAPHYLOCOCCI
> R R R N/R
16 R I I N/R
8 I I I N/R
4 I S S N/R
2 S S S N/R
2. Use for PBC20, PBC23, PC1A, PC20 and PC21 panels.
3. The CLSI interpretative guideline for Vancomycin with streptococci is ≤0.5 for susceptible. Because
intermediate and resistant interpretations have not been defined for streptococci, all MICs of ≥2 will
report as N/R, since these dilutions do not differentiate between S and NS.
9020-7493B Page 111 of 158

®
SYNERGIES PLUS GRAM-NEGATIVE PANELS
> R R R
32 I I I
16 S S S
8 S S S
Amoxicillin- MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.

K Clavulanate (Aug)
> R
16/8 R
4/2 S
® ®
2. Use for Synergies plus Neg Combo Type 3 panels and Synergies plus Neg/Urine Combo Type 4 panels
®
3. Rapid results (<16 hrs) are not provided for Amoxicillin-K Clavulanate on Synergies plus Gram-Negative
Amoxicillin- MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA B PSEUDOMALLEI

K Clavulanate (Aug)
> R
16/8 I
8/4 S
®
2. Rapid results (<16 hrs) are not provided for Amoxicillin-K Clavulanate on Synergies plus Gram-Negative
Ampicillin (Am) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA V. CHOLERAE
> R
16 I
8 S
4 S
2 S
2. Do not report drug, therapy or MIC for P. vulgaris or Shigella spp. See back of therapy guide for species
names.
3. For the following groups, Citrobacter spp., Enterobacter spp., Klebsiella spp. or Providencia spp., do not
®
report rapid Synergies plus results (<16 hrs) for drug, therapy or MIC. Overnight results (16-20 hrs) can be
reported. See back of therapy guide for species names.
®
4. For rapid Synergies plus results (<16 hrs), intermediate and resistant MICs obtained for P. mirabilis must be
®
confirmed with overnight incubation (16-20 hours) of the Synergies plus panels.
6. Do not report therapy for Aeromonas spp., Plesiomonas shigelloides, and V. cholerae.
9020-7493B Page 112 of 158

®
Amp-Sulbactam (A/S) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

(Acinetobacter spp. only)
> R
16/8 I
8/4 S
4/2 S
® ®
2. Use for the Synergies plus Neg BP Combo Type 8 and Synergies plus Neg Combo Type 2 panels panels.
3. Do not report drug, therapy or MIC for the following groups: Citrobacter spp., Enterobacter spp., M. morganii,
Salmonella spp. or Shigella spp. See back of therapy guide for species names.
4. Do not report therapy for Acinetobacter spp. because “according to the FDA approved pharmaceutical
manufacturer’s package insert, sufficient strains of Acinetobacter spp. have not been tested to establish
efficacy with Ampicillin-Sulbactam.”
> R R R
16 I I I
8 S S S
®
2. Rapid results (<16 hrs) are not provided for Aztreonam on Synergies plus Gram-Negative panels.
Results are available at 16-20 hours.
3. Aztreonam cannot be used as a Screening antimicrobial agent for extended-spectrum beta-lactamases
®
(ESBL) on Synergies plus panels.
®
4. On Synergies plus panels, ESBL-a and ESBL-b can be used as Screening antimicrobial agents for
extended-spectrum beta-lactamases (ESBL), see information under ESBL-a and ESBL-b.
> R
16 I
8 S
® ®
2. Use for Synergies plus Neg Combo Type 3 panels, Synergies plus Neg/Urine Combo Type 4 panels,
®
Synergies plus Neg BP Combo Type 8 panels.
3. Do not report drug, therapy or MIC for K. oxytoca, K. pneumoniae/oxytoca and Klebsiella spp.
4. Due to expected natural resistance to Cefazolin, drug, MIC and interpretative results from
Enterobacter spp., C. freundii Group, M. morganii, P. vulgaris, P. penneri, Providencia spp., Serratia
spp. or Y. enterocolitica will not be reported in the software or on patient reports. See back of therapy
results can occur.
9020-7493B Page 113 of 158

®
> R
16 I
8 S
® ®
2. Use for the Synergies plus Neg BP Combo Type 7 and Synergies plus Neg Combo Type 2 panels.
®
3. Rapid results (<16 hrs) are not provided for Cefazolin for the Synergies plus Gram-Negative panels
listed in Note 2. Results are available 16-20 hours.
results can occur.
> R R
32 R R
4 N/R S
®
2. Use for Synergies plus Neg Combo Type 3 panel.
®
3. Rapid results (<16 hrs) are not provided for Cefepime on Synergies plus Gram-Negative panels. Results
are available at 16-20 hours.
5. Based on EUCAST interpretive guidelines for Enterobacteriaceae, all MICs of ≤4 will report as N/R, since
> R R R
16 I I I
8 S S S
NOTE: 1. Therapy based CLSI M100-S22.
®
2. Rapid results (<16 hrs) are not provided for Cefepime on Synergies plus Gram-Negative panels. Results
are available at 16-20 hours.
9020-7493B Page 114 of 158

®
> R R
32 I I
8 S S
4 S S
® ®
2. Use for the Synergies plus Neg/Urine Combo Type 4 and Synergies plus Neg BP Combo Type 8 panel.
3. Cefotaxime cannot be used as a Screening antimicrobial agent for extended-spectrum beta-lactamases
®
®
5. Do not report drug, therapy or MIC for Acinetobacter spp., C. freundii Group, E. cloacae, Klebsiella
spp., or Proteus spp. See back of therapy guide for species names.
®
6. For rapid Synergies plus results (<16 hrs), do not report drug, therapy or MIC for S. marcescens
with MICs of >32 (I, R).
®
7. For rapid Synergies plus results (<16 hrs), intermediate/resistant MICs obtained for S. marcescens
®
must be confirmed with overnight incubation (16-20 hrs) of the Synergies plus panels.
10. Do not report therapy for P aeruginosa based on CLSI M100-S22.
> R R
32 I I
16 I I
8 S S
2 S S
® ®
2. Use for the Synergies plus Neg BP Combo Type 7, Synergies plus Neg/Urine Combo Type 2 and
®
Synergies plus Neg/Urine Combo Type 1 panels.
®
3. Rapid results (<16 hrs) are not provided for Cefotaxime on the Synergies plus Gram-Negative
panels listed in Note 2. Results are available at 16-20 hours.
5. Cefotaxime cannot be used as a Screening antimicrobial agent for extended-spectrum beta-
®
lactamases (ESBL) on Synergies plus panels.
®
8. Do not report therapy for P. aeruginosa based on CLSI M100-S22.
Cefotaxime (Cft) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P AERUGINOSA
>
16
2
2. For ESBL Confirmation only.
®
3. Use for the Synergies plus Neg Combo Type 3.
®
4. Rapid results (<16 hours) are not provided for Cefotaxime on Synergies plus Neg Combo Type 3
5. Cefotaxime is a confirmation antimicrobial agent for extended-spectrum beta-lactamases (ESBL).
For overnight (16-20 hrs) results, see ESBL information in front of therapy guide.
9020-7493B Page 115 of 158

®
ESBL Confirm Cefotaxime MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P AERUGINOSA B PSEUDOMALLEI

(ECft)
>
16
2
NOTE: 1. For ESBL Confirmation only.
®
2. ECft is Cefotaxime. Rapid results (<16 hours) are not provided for ECft on Synergies plus Gram-
negative panels. Results are available at 16-20 hours.
3. ECft is a confirmation antimicrobial agent for extended-spectrum beta-lactamases (ESBL). For
Overnight results (16-20 hrs), see ESBL information in front of guide.
Cefotaxime-K MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

Clavulanate (Cft/CA)
>
4/4
0.5/4
®
NOTE: 1. On Synergies plus panels, Cefotaxime-K Clavulanate is a confirmation antimicrobial for extended
-spectrum beta-lactamases (ESBL). See ESBL information in front of guide.
®
2. Rapid results (<16 hrs) are not provided for Cefotaxime-K Clavulanate on the Synergies plus
Gram-Negative panels. Results are available at 16-20 hours.
Cefotetan (Ctn) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
32 I
16 S
®
2. Rapid results (<16 hrs) are not provided for Cefotetan on Synergies plus Gram-Negative panels.
results can occur.
> R
16 I
8 S
®
2. Rapid results (<16 hrs) are not provided for Cefoxitin on Synergies plus Gram-Negative
panels. Results are available 16-20 hours.
3. Do not report therapy for Salmonella/Shigella group and Y. pestis because dangerously
Cefoxitin (Cfx) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P AERUGINOSA
> R
32 I
8 S
® ®
2. Use for Synergies plus Neg Combo Type 3 panels and Synergies plus Neg/Urine Combo Type 4
panels
®
3. Rapid results (<16 hrs) are not provided for Cefoxitin on Synergies plus Gram-Negative panels.
9020-7493B Page 116 of 158
®
Ceftazidime (Caz) MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA B. PSEUDOMALLEI

ENTEROBACTERIACEAE
> R R R R
16 I I I I
8 S S S S
4 S S S S
2 S S S S
®
2. For E. cloacae, do not report rapid Synergies plus results (<16 hrs) for drug, therapy or MIC.
Overnight results (16-20 hrs) can be reported.
3. Ceftazidime cannot be used as a Screening antimicrobial agent for extended-spectrum beta-lactamases
®
®
4. On Synergies plus panels, ESBL-a and ESBL-b can be used as screening antimicrobial agents for
ESBL Confirm MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA B. PSEUDOMALLEI

ENTEROBACTERIACEAE
Ceftazidime (ECaz)
>
8
1
NOTE: 1. For ESBL Confirmation only.
®
2. ECaz is Ceftazidime. Rapid results (<16 hrs) are not provided for ECaz on Synergies plus Gram-
Negative panels. Results are available at 16-20 hours.
3. ECaz is a confirmation antimicrobial agent for extended-spectrum beta-lactamases (ESBL). For
Dried Overnight results and ESBL Confirmation organisms, see ESBL information in front of guide.
Ceftazidime-K MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

Clavulanate (Caz/CA)
>
2/4
0.25/4
®
NOTE: 1. Rapid results (<16 hrs) are not provided for Ceftazidime-K Clavulanate on Synergies plus Gram-
Negative panels. Results are available 16-20 hours.
®
2. On Synergies plus panels, Ceftazidime-K Clavulanate is a confirmation antimicrobial for extended-
spectrum beta-lactamases (ESBL). See ESBL information in front of guide.
> R R
32 I I
8 S S
2. Do not report drug, therapy or MIC for P. vulgaris.
®
3. For Citrobacter spp. or E. cloacae, do not report rapid Synergies plus results (<16 hrs) for drug,
therapy or MIC. Overnight results (16-20 hrs) can be reported. See back of therapy guide for
species names.
4. Ceftriaxone cannot be used as a screening antimicrobial agent for extended-spectrum beta-
®
lactamases (ESBL) on Synergies plus panels.
®
5. On Synergies plus panels, ESBL-a and ESBL-b can be used as screening antimicrobial agents for
7. Do not report therapy for B. cepacia, B. pseudomallei, S. maltophilia and Vibrio spp.
8. Do not report therapy for P. aeruginosa based on CLSI M100-S22.
9020-7493B Page 117 of 158

®

(parenteral)
> R
16 I
8 S
4 S
®
2. For Enterobacter spp. or K. pneumoniae, do not report rapid Synergies plus results (<16 hrs) for drug,
therapy or MIC. Overnight results (16-20 hrs) can be reported. See back of therapy guide for species
names.
results can occur.
4. The CLSI M100-S22 breakpoints for Enterobacteriaceae and Cefuroxime axetil (oral) are S≤4, R=8-
16, R≥32.
> R
16 I
8 S
2. Report for Urine source only.
3. Rapid results (<16 hrs) are not provided for Cephalothin on Synergies plus Gram-Negative panels.
4. Do not report therapy for Salmonella/Shigella group and Y. pestis because dangerously misleading results
can occur.
Plesiomonas shigelloides, S. maltophilia and Vibrio spp.
Ciprofloxacin (Cp) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P AERUGINOSA Y. PESTIS
> R R R R
2 I I I I
1 S S S S
0.5 S S S S
3. For Y. pestis therapy based on CLSI M100-S17 interpretive breakpoints.
> R R
4 R S
2 S S
®
2. Rapid results (<16 hrs) are not provided for Colistin on Synergies plus Gram-Negative panels.
9020-7493B Page 118 of 158

®
ESBL-a (ESa) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
>
4
®
NOTE: 1. ESBL-a is Cefpodoxime. Rapid results (<16 hrs) are not provided for ESBL-a on Synergies plus
2. ESBL-a is a screening antimicrobial agent for extended-spectrum beta-lactamases (ESBL). For Dried
Overnight results and E. coli, K. oxytoca, K. pneumoniae and P. mirabilis, see ESBL information in
front of guide.
ESBL-b (ESb) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
>
1
®
NOTE: 1. ESBL-b is Ceftazidime. Rapid results (<16 hrs) are not provided for ESBL-b on Synergies plus
2. ESBL-b is a screening antimicrobial agent for extended-spectrum beta-lactamases (ESBL). For Dried
Overnight results and E. coli, K. oxytoca, K. pneumoniae and P. mirabilis, see ESBL information in
front of therapy guide.
> R R
32 S S
®
2. Rapid results (<16 hrs) are not provided for Fosfomycin on Synergies plus Gram-Negative panels.
Gatifloxacin (Gat) MIC ENTEROBACTERIACEAE A. LWOFFII P. AERUGINOSA
> R R
4 I I
2 S S
® ®
2. Use for the Synergies plus Neg BP Combo Type 7, Synergies plus Neg/Urine Combo Type 2,
® ®
Synergies plus Neg/Urine Combo Type 1 and Synergies plus Neg Combo Type 2 panels.
3. Do not report drug, therapy or MIC for P. aeruginosa and Non-Enterobacteriaceae, except A. lwoffii.
Gentamicin (Gm) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA Y. PESTIS
> R R R R
8 I I I I
4 S S S S
2 S S S S
1 S S S S
9020-7493B Page 119 of 158

®
Imipenem (Imp) MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA B. PSEUDOMALLEI

ENTEROBACTERIACEAE
> R R R R
8 I I I I
4 S S S S
3. Do not report therapy for B. cepacia and S. maltophilia.
Levofloxacin (Lvx) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R R R
4 I I I
2 S S S
Levofloxacin (Lvx) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R R
4 R R R
1 S S S
0.5 S S S
®
2. Use for Synergies plus Neg Combo Type 3 panel.
®
3. Rapid results (<16 hrs) are not provided for Levofloxacin on Synergies plus Neg Combo Type 3
5. Based on EUCAST interpretive guidelines for Enterobacteriaceae, Acinetobacter spp. and
Pseudomonas spp., all MICs of >1 will report as R, since these dilutions do not differentiate between
I and R (S≤1, I=2, R>2).
> R R R
8 I I I
4 S S S
® ®
2. Use for the Synergies plus Neg BP Combo Type 7 and Synergies plus Neg Combo Type 2 panels.
®
3. For P. aeruginosa, do not report rapid Synergies plus results (<16 hrs) drug, therapy or MIC.
Overnight results (16-20 hrs) can be reported.
9020-7493B Page 120 of 158

®
Nalidixic Acid (NA) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P AERUGINOSA
> R
16 I
8 S
®
3. Rapid results (<16 hrs) are not provided for Nalidixic Acid on Synergies plus Gram-Negative panels.
4. Do not report drug, therapy or MIC for E. cloacae and K. pneumoniae.
®
5. Do not report therapy for Salmonella because the ability of the Synergies plus panels to detect
> R
64 I
32 S
16 S
® ®
2. Use for the Synergies plus Neg BP Combo Type 7, Synergies plus Neg BP Combo Type 8
®
and Synergies plus Neg/Urine Combo Type 4 panels.
4. Due to expected natural resistance to Nitrofurantoin, drug, MIC and interpretative results from M.
morganii, Proteus spp., Providencia spp. or Serratia spp. will not be reported in the software or on
patient reports. See back of therapy guide for species names.
> R
64 I
32 S
® ®
2. Use for the Synergies plus Neg/Urine Combo Type 1 and Synergies plus Neg/Urine Combo Type 2
panels.
®
3. Rapid results (<16 hrs) are not provided for Nitrofurantoin on the Synergies plus Gram-Negative
panels listed in Note 2. Results are available at 16-20 hours.
> R R R
8 I I I
4 S S S
®
2. Use for Synergies plus Neg/Urine Combo Type 4 panel.
9020-7493B Page 121 of 158

®
> R R R
8 I I I
4 S S S
®
2. Use for Synergies plus Neg BP Combo Type 8 panels.
®
3. Rapid results (<16 hrs) are not provided for Norfloxacin on the Synergies plus Gram-Negative panels
listed in Note 2. Results are available at 16-20 hours.
Piperacillin (Pi) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.
> R R
64 R R
16 I S
8 S S
NOTE: 1. Therapy based on EUCAST
®
2. Use for the Synergies plus Neg/Urine Combo Type 4.
®
3. Rapid results (<16 hrs) are not provided for Piperacillin on Synergies plus Gram-Negative panels.
> R R R
64 I I S
32 I I S
16 S S S
® ®
2. Use for the Synergies plus Neg BP Combo Type 8 and Synergies plus Neg/Urine Combo Type 1
panels.
3. Do not report drug, therapy or MIC for S. maltophilia or Citrobacter spp. See back of therapy guide for
species names.
®
4. For Acinetobacter spp., K. oxytoca, M. morganii or P. mirabilis, do not report rapid Synergies plus
results (<16 hrs) for drug, therapy or MIC. Overnight results (16-20 hrs) can be reported. See back of
therapy guide for species names.
6. Do not report therapy for Aeromonas spp., B. cepacia, B. pseudomallei, and Plesiomonas
shigelloides.
9020-7493B Page 122 of 158

®

(P/T)
> R R R
64 I I S
32 I I S
16 S S S
8 S S S
® ®
2. Use for the Synergies plus Neg Combo Type 2, Synergies plus Neg BP Combo Type 8,
® ®
Synergies plus Neg Combo Type 3 and Synergies plus Neg/Urine Combo Type 4 panels.
3. Do not report drug, therapy, or MIC for S. maltophilia and Acinetobacter spp. See back of therapy guide for
species names.
®
4. For Citrobacter spp. or Enterobacter spp., do not report rapid Synergies plus results (<16 hrs) for drug,
therapy or MIC. Overnight results (16-20 hrs) can be reported. See back of therapy guide for species
names.
®
5. For rapid Synergies plus results (<16 hrs), do not report drug, therapy or MIC for Serratia spp. with MICs of
≥ 32 (I, R).
®
6. For rapid Synergies plus results (<16 hrs), intermediate/resistant MICs obtained for Serratia spp. must be
®
confirmed with overnight incubation (16-20 hrs) of the Synergies plus panels.

(P/T)
> R R R
64 I I I
16 S S S
® ®
2. Use for the Synergies plus Neg BP Combo Type 7, Synergies plus Neg/Urine Combo Type 1 and
®
Synergies plus Neg/Urine Combo Type 2 panels.
®
3. Rapid results (<16 hrs) are not provided for Piperacillin-Tazobactam on the Synergies plus Gram-
Negative panels listed in Note 2. Results are available at 16-20 hours.
4. Do not report drug, therapy or MIC for S. maltophilia and Acinetobacter spp. See back of therapy
Tetracycline (Te) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA V. CHOLERAE
> R R
8 I I
4 S S
2 S S

> R R
8 I I
4 S S
2 S S
pseudomallei) therapies based on CLSI M100-S22. B. pseudomallei and Y. pestis therapies based
on CLSI M45-A2.
® ®
2. Use these tables for the Synergies plus Neg BP Combo Type 8 and Synergies plus Neg/Urine
Combo Type 1 panels.
3. Do not report therapy for B. cepacia, S. maltophilia and V. cholerae.
9020-7493B Page 123 of 158

®
> R R
64 R R
16 N/R S
® ®
2. Use for Synergies plus Neg Combo Type 3 panels and Synergies plus Neg/Urine Combo Type 4 panels.
®
3. Rapid results (<16 hrs) are not provided for Ticarcillin on Synergies plus Gram-Negative panels.
4. Do not report drug, therapy, or MIC for S. maltophilia.
Ticarcillin- MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.

K Clavulanate (Tim)
> R R
64 R R
16 N/R S
® ®
2. Use for Synergies plus Neg Combo Type 3 panels and Synergies plus Neg/Urine Combo Type 4 panels.
®
3. Rapid results (<16 hrs) are not provided for Ticarcillin-K Clavulanate on Synergies plus Gram-Negative

K Clavulanate (Tim)
> R R R
64 I I S
16 S S S
®
2. Rapid results (<16 hrs) are not provided for Ticarcillin-K Clavulanate on Synergies plus Gram-
Negative panels. Results are available at 16-20 hours.
4. Do not report therapy for Aeromonas spp., B. pseudomallei, Plesiomonas shigelloides and Vibrio spp.
Tobramycin (To) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P AERUGINOSA
> R R R
8 I I I
4 S S S
2 S S S
9020-7493B Page 124 of 158

®
Trimethoprim (T) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA
> R
8 S
®
2. Rapid results (<16 hrs) are not provided for Trimethoprim on Synergies plus Gram-Negative panels.
Trimethoprim- MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P AERUGINOSA

> R R
2/38 S S
MIC B PSEUDOMALLEI Y PESTIS

> R R
2/38 S S
®
2. For rapid Synergies plus panel results (<16 hrs), do not report drug, therapy or MIC for P. aeruginosa.
3. For overnight results (16-20 hours), do not report therapy for P. aeruginosa.
4. Do not report therapy for V. cholerae, sufficient strains were not tested to establish efficacy. Interpretive
breakpoints should not be reported.
9020-7493B Page 125 of 158

®
SYNERGIES PLUS GRAM-POSITIVE PANELS
Ampicillin (Am) MIC STAPHYLOCOCCI ENTEROCOCCI
> R
32 R
16 R
8 S
4 S
2 S
1 S
2. Use for enterococci.
3. For enterococci, if beta-lactamase positive, report Ampicillin as Blac regardless of MIC.
4. The predicted interpretation for staphylococci will be based on the Penicillin and/or Oxacillin MICs.
Chloramphenicol (C) MIC STAPHYLOCOCCI ENTEROCOCCI
> R R
16 I I
8 S S
4 S S
Clindamycin (Cd) MIC STAPHYLOCOCCI ENTEROCOCCI
> R
2 I
1 I
0.5 S
0.25 S
0.12 S
3. Do not report drug, therapy or MIC for enterococci.
4. For staphylococci, if Erythromycin MIC is N/R and Clindamycin MIC is ≤2, do not report therapy.
Erythromycin (E) MIC STAPHYLOCOCCI ENTEROCOCCI
> R
4 I
2 I
1 I
0.5 S
9020-7493B Page 126 of 158

®
Gentamicin (Gm) MIC STAPHYLOCOCCI ENTEROCOCCI
> R
8 I
4 S
2 S
1 S
0.5 S
0.25 S
Imipenem (Imp) MIC STAPHYLOCOCCI ENTEROCOCCI

(E. faecalis only)
> R
8 I
4 S
2 S
1 S
0.5 S
NOTE: 1. Therapy based on FDA approved breakpoints for E. faecalis.
2. Do not report drug, therapy or MIC for enterococci (except for E. faecalis.)
3. The predicted interpretation for staphylococci will be based on the Penicillin and/or Oxacillin MICs.
Levofloxacin (Lvx) MIC STAPHYLOCOCCI ENTEROCOCCI
> R R
4 R I
2 I S
1 S S
0.5 S S
0.25 S S
Linezolid (Lzd) MIC STAPHYLOCOCCI ENTEROCOCCI
> R R
4 S I
2 S S
1 S S
0.5 S S
Nitrofurantoin (Fd) MIC STAPHYLOCOCCI ENTEROCOCCI
> R R
64 I I
32 S S
16 S S
9020-7493B Page 127 of 158

®
Oxacillin (Ox) MIC S. AUREUS & OTHER ENTEROCOCCI

> R R
2 S R
1 S R
0.5 S R
0.25 S S
0.12 S S
3. For rapid results (<16 hours), do not report drug, therapy or MIC for S. aureus with Oxacillin MICs <4
and coagulase-negative staphylococci with Oxacillin MICs <0.5. Results are available at 16-20 hours.
Penicillin (P(E)) MIC STAPHYLOCOCCI ENTEROCOCCI
> R
64 R
32 R
16 R
8 S
4 S
2 S
2. Use for enterococci.
Penicillin (P(S)) MIC STAPHYLOCOCCI ENTEROCOCCI
> R
0.12 S
0.06 S
0.03 S
2. Use for staphylococci.
4. For S. aureus and S. lugdunensis, if Oxacillin MIC is >2, report Penicillin as resistant regardless of MIC.
Rifampin (Rif) MIC STAPHYLOCOCCI ENTEROCOCCI
> R
2 I
1 S
0.5 S
0.25 S
9020-7493B Page 128 of 158

®
Synercid (Syn) MIC STAPHYLOCOCCI ENTEROCOCCI

(E. faecium)
> R R
2 I I
1 S S
0.5 S S
0.25 S S
0.12 S S
2. It is important to speciate strains of enterococci, since Synercid is only active against E. faecium.
3. Do not report drug, therapy or MIC for all enterococci, except E. faecium.
Teicoplanin (Tei) MIC STAPHYLOCOCCI ENTEROCOCCI
> R R
16 I I
8 S S
4 S S
2 S S
1 S S
Tetracycline (Te) MIC STAPHYLOCOCCI ENTEROCOCCI
> R R
8 I I
4 S S
2 S S
1 S S
0.5 S S
Trimethoprim- MIC STAPHYLOCOCCI ENTEROCOCCI

> R
2/38 S
1/19 S
0.5/9.5 S
Vancomycin (Va) MIC S. aureus COAGULASE- NEGATIVE ENTEROCOCCI

STAPHYLOCOCCI
> R R R
16 R I I
8 I I I
4 I S S
2 S S S
1 S S S
0.5 S S S
0.25 S S S
2. For rapid results (<16 hrs), do not report drug, therapy or MIC for S. aureus with MICs of 8 or 16.
Final results will be reported after overnight incubation (16-20 hrs).
9020-7493B Page 129 of 158
FASTIDIOUS PANELS - STREPTOCOCCI
Amoxicillin/ MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

(Group A, B, C and G) STREPTOCOCCI
K Clavulanate (Aug)
> R
4/2 I
2/1 S
1/0.5 S
NOTE: 1. Streptococci (Group A, B, C and G) and viridans streptococci therapies based on EUCAST V3.1.
2. S. pneumoniae therapy based on CLSI M100-S22.
®
3. Use for MICroSTREP plus 6E panel only.
4. For all streptococci (except S. pneumoniae) refer to the penicillin result.
Amoxicillin/ MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

K Clavulanate (Aug)
>
4/2
2/1
1/0.5
0.5/0.25
0.25/0.12
®
2. Use for MICroSTREP plus 5 panel only.
3. For all streptococci refer to the penicillin result.
Amoxicillin- MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

K Clavulanate (Aug)
> R
4/2 I
2/1 S
1/0.5 S
0.5/0.25 S
0.25/0.12 S
Ampicillin (Am) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
4 R - R
2 I - I
1 I - I
0.5 S - S
0.25 S S S
0.12 S S S
0.06 S S S
NOTE: 1. S. pneumoniae and viridans streptococci therapies based on EUCAST V3.1.
2. Beta-hemolytic streptococci therapy based on CLSI M100-S22.
®
Because intermediate and resistant interpretations have not been defined, no interpretations will be
provided if the result is >0.25.
9020-7493B Page 130 of 158

Ampicillin (Am) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
16 R R
8 R R
4 R R
2 I I
1 I I
0.5 S S
0.25 S S
0.12 S S
0.06 S S
0.03 S S
®
3. For streptococci (Group A, B, C and G) refer to the penicillin result.
Ampicillin (Am) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> - R
8 - R
4 - I
2 - I
1 - I
0.5 - I
0.25 S S
0.12 S S
0.06 S S
0.03 S S
Azithromycin (Azi) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R R
2 R R R
1 R R I
0.5 I I S
0.25 S S S
0.12 S S S
NOTE: 1. S. pneumoniae and Streptococci (Group A, B, C and G) therapies based on EUCAST V3.1.
®
5. Susceptibility and resistance to Azithromycin can be predicted by testing Erythromycin.
9020-7493B Page 131 of 158

Azithromycin (Azi) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R R R
4 R R R
2 R R R
1 I I I
0.5 S S S
0.25 S S S
0.12 S S S
3. Susceptibility and resistance to Azithromycin can be predicted by testing Erythromycin.
Cefaclor (Cfr) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R
16 R
8 R
4 R
2 I
1 S
0.5 S
Cefepime (Cpe) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
2 I - R
1 S - R
0.5 S S S
0.25 S S S
®
3. Use for MICroSTREP plus 6E panel only
Cefepime (Cpe) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
2 I - I
1 S - S
0.5 S S S
0.25 S S S
0.12 S S S
9020-7493B Page 132 of 158

Cefotaxime (Cft) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
2 I - R
1 I - R
0.5 S S S
0.25 S S S
®
3. Use for MICroSTREP plus 6E panels only.
4. The CLSI interpretative guideline for Cefotaxime with beta-hemolytic streptococci is ≤0.5 for
susceptible. Because intermediate and resistant interpretations have not been defined, no
Cefotaxime (Cft) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
32 R R
16 R R
8 R R
4 R R
2 I R
1 I R
0.5 S S
0.25 S S
0.12 S S
®
2. Use for MICroSTREP plus 5 panels only.
Cefotaxime (Cft) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

(Meningitis) STREPTOCOCCI STREPTOCOCCI
> R - R
8 R - R
4 R - R
2 R - I
1 I - S
0.5 S S S
0.25 S S S
0.12 S S S
0.06 S S S
0.03 S S S
2. The CLSI interpretative guideline for Cefotaxime with beta-hemolytic streptococci is ≤0.5 for
susceptible. Because intermediate and resistant interpretations have not been defined, no
3. For S. pneumoniae, Cefotaxime breakpoints are based on isolates from CSF (meningitis). For all other
S. pneumoniae isolates report both meningitis breakpoints (S≤0.5, I=1, R≥2) and non-meningitis
breakpoints (S≤1, I=2, R≥4).
4. Results of testing Cefotaxime should be routinely reported for CSF isolates of S. pneumoniae.
9020-7493B Page 133 of 158

Ceftriaxone (Cax) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
2 I - R
1 I - R
0.5 S S S
0.25 S S S
2. Beta-Hemolytic therapy based on CLSI M100-S22.
®
3. Use for MICroSTREP plus 6E panels only.
4. The CLSI interpretative guideline for Ceftriaxone with beta-hemolytic streptococci is ≤0.5 for susceptible.
Ceftriaxone (Cax) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
8 R R
4 R R
2 I R
1 I R
0.5 S S
0.25 S S
0.12 S S
®
Ceftriaxone (Cax) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
2 R - I
1 I - S
0.5 S S S
0.25 S S S
2. The CLSI interpretative guideline for Ceftriaxone with beta-hemolytic streptococci is ≤0.5 for susceptible.
3. For S. pneumoniae, Ceftriaxone breakpoints are based on isolates from CSF (meningitis). For all other
S. pneumoniae isolates report both meningitis breakpoints (S≤0.5, I=1, R≥2) and non-meningitis
breakpoints (S≤1, I=2, R≥4).
4. Results of testing Ceftriaxone should be routinely reported for CSF isolates of S. pneumoniae.
Cefuroxime sodium (Crm) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

(parenteral)
> R R
4 R R
2 R R
1 I R
0.5 S S
0.25 S S
® ®
2. Use for MICroSTREP plus 5 and MICroSTREP plus 6E panels.
9020-7493B Page 134 of 158
Cefuroxime sodium (Crm) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

(parenteral)
> R
8 R
4 R
2 R
1 I
0.5 S
0.25 S
2. The CLSI breakpoints for Cefuroxime axetil (oral) are S≤1, I=2, R≥4.
Chloramphenicol (C) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R R
8 S S I
4 S S S
2 S S S
NOTE: 1. S. pneumoniae and streptococci (Group A, B, C, and G) therapies based on EUCAST V3.1.
®
Chloramphenicol (C) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
16 R R
8 S S
4 S S
2 S S
®
Chloramphenicol (C) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R R R
16 R R R
8 R I I
4 S S S
2 S S S
1 S S S
9020-7493B Page 135 of 158

Ciprofloxacin (Cp) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

>
4
2
1
0.5
0.25
0.12
0.06
® ®
2. Use for MICroSTREP plus 3 and MICroSTREP plus 5 panels.
Clarithromycin (Cla) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R R
2 R R R
1 R R R
0.5 I I I
0.25 S S S
0.12 S S S
NOTE: 1. S. pneumoniae and streptococci (Group A, B, C and G) therapies based on EUCAST V3.1.
®
4. Susceptibility and resistance to Clarithromycin can be predicted by testing Erythromycin.
Clarithromycin (Cla) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R R R
2 R R R
1 R R R
0.5 I I I
0.25 S S S
0.12 S S S
2. Susceptibility and resistance to Clarithromycin can be predicted by testing Erythromycin.
Clindamycin (Cd) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R R
4 R R R
2 R R R
1 R R R
0.5 S S S
0.25 S S S
0.12 S S S
0.06 S S S
® ®
9020-7493B Page 136 of 158

Clindamycin (Cd) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R R R
2 R R R
1 R R R
0.5 I I I
0.25 S S S
0.12 S S S
0.06 S S S
Daptomycin (Dap) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R -
2 R -
1 S S
0.5 S S
0.25 S S
NOTE: 1. Streptococci (Group A, B, C and G) therapy based on EUCAST V3.1.
®
4. The CLSI interpretative guideline for viridans streptococci is ≤ 1 for susceptible. Because intermediate and
resistant interpretations have not been defined, no interpretations will be provided if the result is >1.
Daptomycin (Dap) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> - -
2 - -
1 S S
0.5 S S
0.25 S S
2. The CLSI interpretative guideline with beta-hemolytic and viridans streptococci is ≤1 for susceptible.
provided if the result is >1.
Erythromycin (E) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R R
0.5 I I I
0.25 S S S
0.12 S S S
0.06 S S S
®
5. Susceptibility and resistance to Azithromycin and Clarithromycin can be predicted by testing
Erythromycin.
9020-7493B Page 137 of 158

Erythromycin (E) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
4 R R
2 R R
1 R R
0.5 N/R N/R
®
4. Susceptibility and resistance to Azithromycin and Clarithromycin can be predicted by testing Erythromycin.
5. Based on EUCAST interpretive guidelines for S. pneumoniae and streptococci (Group A, B, C and G),
all MICs of ≤0.5 will report as N/R, since these dilutions do not differentiate between S and I (S≤0.25,
I=0.5, R>0.5).
Erythromycin (E) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R R R
4 R R R
2 R R R
1 R R R
0.5 I I I
0.25 S S S
0.12 S S S
0.06 S S S
3. Susceptibility and resistance to Azithromycin and Clarithromycin can be predicted by testing Erythromycin.
Gatifloxacin (Gat) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

>
2
1
0.5
0.25
0.12
NOTE: 1. Do not report drug, therapy or MIC.
Levofloxacin (Lvx) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS STREPTOCOCCI

(Group A, B, C and G)
> R R R
4 R R I
2 S I S
1 S S S
0.5 S S S
®
9020-7493B Page 138 of 158

Levofloxacin (Lvx) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
8 R R
4 R R
2 S I
1 S S
0.5 S S
0.25 S S
®
Levofloxacin (Lvx) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R R R
4 I I I
2 S S S
1 S S S
0.5 S S S
0.25 S S S
Linezolid (Lzd) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS STREPTOCOCCI

(Group A, B, C and G)
> R R -
4 I I -
2 S S S
1 S S S
®
4. The CLSI interpretative guideline for viridans streptococci is ≤2 for susceptible. Because intermediate and
resistant interpretations have not been defined, no interpretations will be provided if the result is >2.
Linezolid (Lzd) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS STREPTOCOCCI

STREPTOCOCCI
> - - -
4 - - -
2 S S S
1 S S S
0.5 S S S
2. The CLSI interpretative guideline with S. pneumoniae, beta-hemolytic streptococci and viridans streptococci
is ≤2 for susceptible. Because intermediate and resistant interpretations have not been defined, no
9020-7493B Page 139 of 158

Meropenem (Mer) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
2 R - S
1 I - S
0.5 I S S
0.25 S S S
NOTE: 1. S. pneumoniae (meningitis) and viridans streptococci therapies based on EUCAST V3.1.
®
4. Report therapy for systemic source only.
5. The CLSI interpretative guideline for beta-hemolytic streptococci is ≤0.5 for susceptible. Because
intermediate and resistant interpretations have not been defined, no interpretations will be provided if the
result is >0.5.
6. Based on EUCAST interpretive guidelines for S. pneumoniae, for infections other than meningitis
breakpoints are S≤2, R>2.
Meropenem (Mer) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

(Meningitis) (Group A, B, C and G) STREPTOCOCCI
> R R
8 R R
4 R R
2 R S
1 I S
0.5 N/R S
®
5. Based on EUCAST v2.0 interpretive guidelines for S. pneumoniae, for infections other than meningitis the
breakpoints are S≤2, R>2.
6. Based on EUCAST interpretive guidelines for S. pneumoniae (meningitis), all MICs of ≤0.5 will report as
N/R, since these dilutions do not differentiate between S and I (S≤0.25, I=0.5-1, R>1).
Meropenem (Mer) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - -
4 R - -
2 R - -
1 R - -
0.5 I S S
0.25 S S S
0.12 S S S
0.06 S S S
3. The CLSI interpretative guideline for Meropenem with beta-hemolytic streptococci and viridans
streptococci is ≤0.5 for susceptible. Because intermediate and resistant interpretations have not been
defined, no interpretations will be provided if the result is >0.5.
4. Results of testing Meropenem should be routinely reported for CSF isolates of S. pneumoniae.
9020-7493B Page 140 of 158

Minocycline (Min) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
2 R R
1 I I
0.5 S S
® ®
2. Use for MICroSTREP plus 6C and MICroSTREP plus 6E panels only.
Moxifloxacin (Mxf) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
2 R R
1 R I
0.5 S S
0.25 S S
®
Moxifloxacin (Mxf) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R
4 R
2 I
1 S
0.5 S
0.25 S
Penicillin (P) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

(meningitis) (Group A, B, C and G) STREPTOCOCCI
> R R R
16 R R R
8 R R R
4 R R R
2 R R I
1 R R I
0.5 R R I
0.25 R S S
0.12 R S S
0.06 S S S
0.03 S S S
® ®
3. For S. pneumoniae, Penicillin breakpoints are based on isolates from CSF (meningitis).
4. For S. pneumoniae isolates from pneumonia, refer to EUCAST v2.0.
5. For S. pneumoniae from sources other than pneumonia or meningitis, the breakpoints are S≤0.06, I=0.12-
2, R>2.
9020-7493B Page 141 of 158

Penicillin (P) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R - R
8 R - R
4 R - R
2 R - I
1 R - I
0.5 R - I
0.25 R - I
0.12 R S S
0.06 S S S
0.03 S S S
2. The CLSI interpretive guideline for Penicillin with beta-hemolytic streptococci is ≤0.12 for susceptible.
Because intermediate and resistant interpretations have not been defined no interpretations will be
3. Results of testing Penicillin should be routinely reported for CSF isolates of S. pneumoniae.
4. For S. pneumoniae, Penicillin breakpoints are based on isolates from CSF (meningitis). For all other
S. pneumoniae isolates report both meningitis breakpoints (S≤0.06, R≥0.12) and non-meningitis breakpoints
(S≤2, I=4, R≥8). Breakpoints for oral administration are S≤0.06, I=0.12-1, R≥2.
Pristinamycin (Prs) MIC S. PNEUMONIAE STREPTOCOCCI
> R R
2 R I
1 S S
® ®
2. Use for MICroSTREP plus 6C and MICroSTREP plus 6E panels only.
Pristinamycin (Prs) MIC S. PNEUMONIAE STREPTOCOCCI
> R R
4 R R
2 N/R N/R
®
3. Based on SFM 2012 interpretive guidelines for S. pneumoniae, all MICs ≤2 will report as N/R, since
4. Based on SFM 2012 interpretive guidelines for other streptococci, all MICs ≤2 will report as N/R, since
Rifampin (Rif) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

>
16
8
4
2
1
®
3. Based on EUCAST interpretive guidelines for all streptococci, these dilutions do not differentiate between S,
I and R (S≤0.06, I=0.12-0.5, R>0.5).
9020-7493B Page 142 of 158

Rifampin (Rif) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R
2 I
1 S
0.5 S
® ® ®
2. Use for MICroSTREP plus 3, MICroSTREP plus 6C and MICroSTREP plus 6E panels.
Tetracycline (Te) MIC S. PNEUMONIAE STREPTOCOCCI ViIRIDANS

> R R R
4 R R I
2 I I S
1 S S S
®
Tetracycline (Te) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
8 R R
4 R R
2 I I
1 S S
0.5 S S
®
Tetracycline (Te) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R R R
4 I I I
2 S S S
1 S S S
0.5 S S S
Trimethoprim- MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R
8/152 R R
4/76 R R
2/38 I I
1/19 S S
0.5/9.5 S S
0.25/4.75 S S
® ®
9020-7493B Page 143 of 158

Trimethoprim- MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> R
2/38 I
1/19 I
0.5/9.5 S
0.25/4.75 S
Vancomycin (Va) MIC S. PNEUMONIAE STREPTOCOCCI VIRIDANS

> R R R
8 R R R
4 R R R
2 S S S
1 S S S
0.5 S S S
0.25 S S S
® ®
Vancomycin (Va) MIC S. PNEUMONIAE BETA-HEMOLYTIC VIRIDANS

> - - -
8 - - -
4 - - -
2 - - -
1 S S S
0.5 S S S
0.25 S S S
0.12 S S S
2. The CLSI interpretative guideline for Vancomycin with streptococci is ≤1 for susceptible. Because
intermediate and resistant interpretations have not been defined for streptococci, no interpretations will
3. Results of testing Vancomycin should be routinely reported for CSF isolates of S. pneumoniae.
9020-7493B Page 144 of 158

FASTIDIOUS PANELS - HAEMOPHILUS
Ampicillin (Am) MIC HAEMOPHILUS
> R
16 R
8 R
4 R
2 R
1 S
0.5 S
0.25 S
0.12 S
0.06 S
0.03 S
®
Ampicillin (Am) MIC HAEMOPHILUS
> R
8 R
4 R
2 I
1 S
0.5 S
0.25 S
0.12 S
0.06 S
0.03 S
®
3. If beta-lactamase positive, report Ampicillin BLac regardless of MIC.
4. Results of testing Ampicillin should be routinely reported for CSF isolates of H. influenzae.
Amoxicillin-K Clavulanate (Aug) MIC HAEMOPHILUS
> R
4/2 S
2/1 S
1/0.5 S
0.5/0.25 S
0.25/0.12 S
®
2. Use for MICroSTREP plus 3 and 5 panels.
9020-7493B Page 145 of 158

Azithromycin (Azi) MIC HAEMOPHILUS
> -
4 S
2 S
1 S
0.5 S
0.25 S
®
4. The CLSI interpretative guideline for Azithromycin with Haemophilus spp. is ≤4 for susceptible.
Because intermediate and resistant interpretations have not been defined for Haemophilus
spp., no interpretations will be provided if the result is >4.
Cefaclor (Cfr) MIC HAEMOPHILUS
> R
16 I
8 S
2 S
1 S
®
Cefepime (Cpe) MIC HAEMOPHILUS
> -
2 S
1 S
0.5 S
0.25 S
0.12 S
®
3. The CLSI interpretative guideline for Cefepime with Haemophilus spp. is ≤2 for susceptible.
Because intermediate and resistant interpretations have not been defined for Haemophilus
spp., no interpretations will be provided if the result is >2.
9020-7493B Page 146 of 158

Cefotaxime (Cft) MIC HAEMOPHILUS
> -
32 -
16 -
8 -
4 -
2 S
1 S
0.5 S
0.25 S
0.12 S
0.06 S
0.03 S
®
3. The CLSI interpretative guidelines for Cefotaxime with Haemophilus spp. is ≤2 for susceptible.
Because intermediate and resistant interpretations have not been defined for Haemophilus spp.,
no interpretations will be provided if the result is >2.
4. Results of testing Cefotaxime should be routinely reported for CSF isolates of H. influenzae.
Ceftriaxone (Cax) MIC HAEMOPHILUS
> -
8 -
4 -
2 S
1 S
0.5 S
0.25 S
0.12 S
®
3. The CLSI interpretative guidelines for Ceftriaxone with Haemophilus spp. is ≤2 for susceptible.
Because intermediate and resistant interpretations have not been defined for Haemophilus spp.,
no interpretations will be provided if the result is >2.
4. Results of testing Ceftriaxone should be routinely reported for CSF isolates of H. influenzae.
Cefuroxime (Crm) MIC HAEMOPHILUS
> R
4 S
2 S
1 S
0.5 S
®
9020-7493B Page 147 of 158

Cefuroxime (Crm) MIC HAEMOPHILUS
> R
8 I
4 S
2 S
1 S
0.5 S
0.25 S
®
Chloramphenicol (C) MIC HAEMOPHILUS
> R
16 R
8 R
4 R
2 S
®
3. Report for systemic source only.
Chloramphenicol (C) MIC HAEMOPHILUS
> R
8 R
4 I
2 S
1 S
®
4. Results of testing Chloramphenicol should be routinely reported for CSF isolates of H. influenzae.
Ciprofloxacin (Cp) MIC HAEMOPHILUS
> R
4 R
2 R
1 R
0.5 S
0.25 S
®
9020-7493B Page 148 of 158

Ciprofloxacin (Cp) MIC

HAEMOPHILUS
> -
2 -
1 S
0.5 S
0.25 S
0.12 S
0.06 S
®
3. The CLSI interpretative guidelines for Ciprofloxacin with Haemophilus spp. is ≤1 for
susceptible. Because intermediate and resistant interpretations have not been defined for
Haemophilus spp., no interpretations will be provided if the result is >1.
MIC HAEMOPHILUS
Clindamycin (Cd)
>
4
2
1
0.5
®
NOTE: 1. Use for MICroSTREP plus 5 panel only.
Clindamycin (Cd) MIC HAEMOPHILUS
>
2
1
0.5
0.25
®
Erythromycin (E) MIC HAEMOPHILUS
>
4
2
1
0.5
®
3. Do not report therapy for H. influenzae.
9020-7493B Page 149 of 158

Erythromycin (E) MIC HAEMOPHILUS
>
4
2
1
0.5
0.25
®
Levofloxacin (Lvx) MIC HAEMOPHILUS
> R
8 R
4 R
2 R
1 S
0.5 S
0.25 S
®
Meropenem (Mer) MIC HAEMOPHILUS
> R
8 R
4 R
2 R
1 I
0.5 N/R
®
4. For H. influenzae, Meropenem breakpoints for non meningitis are S≤2, R>2.
5. Based on EUCAST interpretive guidelines for meningitis, all MICs of ≤0.5 will report as N/R since these
dilutions do not differentiate between S and I (S≤0.25, I=0.5-1, R>1).
Meropenem (Mer) MIC HAEMOPHILUS

> -
4 -
2 -
1 -
0.5 S
0.25 S
0.12 S
0.06 S
®
3. The CLSI interpretative guidelines for Meropenem with Haemophilus spp. is ≤0.5 for susceptible. Because
intermediate and resistant interpretations have not been defined for Haemophilus spp, no interpretations will
be provided if the result is >0.5.
5. Results of testing Meropenem should be routinely reported for CSF isolates of H. influenzae.
9020-7493B Page 150 of 158

Penicillin (P) MIC HAEMOPHILUS
>
16
8
4
2
1
0.5
0.25
0.12
0.06
0.03
® ®
NOTE: 1. Use for MICroSTREP plus 5 and MICroSTREP plus 3 panels only.
Pristinamycin (Prs) MIC HAEMOPHILUS
>
4
2
®
Rifampin (Rif) MIC HAEMOPHILUS
> R
16 R
8 R
4 R
2 I
1 S
0.5 S
®
Tetracycline (Te) MIC HAEMOPHILUS
> R
8 R
4 R
2 I
1 S
0.5 S
®
Tetracycline (Te) MIC HAEMOPHILUS
> R
4 I
2 S
1 S
®
9020-7493B Page 151 of 158

Trimethoprim/Sulfamethoxazole MIC HAEMOPHILUS
(T/S)
> R
8/152 R
4/76 R
2/38 R
1/19 I
0.5/9.5 S
®
Trimethoprim-Sulfamethoxazole MIC HAEMOPHILUS

(T/S)
> R
2/38 I
1/19 I
0.5/9.5 S
0.25/4.75 S
®
Vancomycin (Va) MIC HAEMOPHILUS
>
8
4
2
1
®
Vancomycin (Va) MIC HAEMOPHILUS
>
8
4
2
1
0.5
®
9020-7493B Page 152 of 158

Species Classifications for Organism Groups
ACINETOBACTER GROUP ENTEROBACTER GROUP

Acinetobacter anitratus/haemolyticus Enterobacter aerogenes
Acinetobacter baumannii Pantoea agglomerans
Acinetobacter baumannii/haemolyticus Enterobacter amnigenus 1
Acinetobacter haemolyticus Enterobacter amnigenus 2
Acinetobacter lwoffii Enterobacter asburiae
Acinetobacter species Enterobacter cancerogenous
Enterobacter cloacae
CITROBACTER GROUP Enterobacter gergoviae
Citrobacter amalonaticus Enterobacter hormaechei
Citrobacter amalonaticus/diversus Enterobacter intermedius
Citrobacter amalonaticus/koseri Enterobacter sakazakii
Citrobacter braakii Enterobacter species
Citrobacter braakii/freundii/sedlakii Enterobacter taylorae
Citrobacter diversus
Citrobacter farmeri ESBL GROUP- SCREENING
Citrobacter freundii complex Escherichia coli
Citrobacter koseri Escherichia coli LYS-/ORN-
Citrobacter sedlakii Escherichia coli O157:H7
Citrobacter species Klebsiella oxytoca
Citrobacter werkmanii Klebsiella pneumoniae/oxytoca
Citrobacter werkmanii/youngae Klebsiella pneumoniae
Citrobacter youngae Proteus mirabilis
CITROBACTER FREUNDII GROUP ESBL GROUP- CONFIRMATION

Citrobacter braakii Citrobacter amalonaticus
Citrobacter freundii complex Citrobacter koseri
Citrobacter braakii/freundii/sedlakii Citrobacter farmeri
Citrobacter werkmanii/youngae Citrobacter koseri
Citrobacter sedlakii Citrobacter species
Citrobacter werkmanii Enterobacter aerogenes
Citrobacter youngae Enterobacter cloacae
Citrobacter species Escherichia coli
Escherichia coli LYS-/ORN-
CITROBACTER AMALONATICUS/KOSERI GROUP Klebsiella oxytoca
Citrobacter amalonaticus/koseri Klebsiella pneumoniae/oxytoca
Citrobacter amalonaticus/diversus Klebsiella pneumoniae
Citrobacter amalonaticus Morganella morganii
Citrobacter farmeri Proteus mirabilis
Citrobacter species Proteus vulgaris
Providencia rettgeri
KLEBSIELLA GROUP Salmonella species
Raoultella (K.) ornithinolytica Serratia marcescens
Klebsiella oxytoca
Klebsiella ozaenae PROTEUS/PROVIDENCIA GROUP
Klebsiella planticola Proteus penneri
Klebsiella pneumoniae Proteus species
Klebsiella pneumoniae/oxytoca Proteus vulgaris
Klebsiella rhinoscleromatis Proteus vulgaris/penneri
Klebsiella species Providencia alcalifaciens 1-2
Klebsiella terrigena Providencia alcalifaciens/rustigianii
Providencia rettgeri
Providencia rustigianii
Providencia species
Providencia stuartii
9020-7493B Page 153 of 158

PROVIDENCIA GROUP MISCELLANEOUS FASTIDIOUS GROUP-NEG

Providencia alcalifaciens 1-2 Actinobacillus actinomycetemcomitans
Providencia alcalifaciens/rustigianii Bordetella parapertussis
Providencia rettgeri Bordetella pertussis
Providencia rustigianii CDC Group EO-2
Providencia species CDC Group EF-4A
Providencia stuartii (urea +/-) CDC Group EF-4B
CDC group EF-4B/Neisseria weaveri/N. elongata
SALMONELLA/SHIGELLA GROUP C. violaceum
Salmonella choleraesuis Eikenella corrodens
Salmonella species Neisseria elongata subspecies nitroreducens
Salmonella typhi Neisseria weaveri (CDC grp M5)
Salmonella/Arizona Pasteurella-Actinobacillus species
Shigella boydii Pasteurella-Actinobacillus species SF
Shigella boydii/dysenteriae/flexneri Pasteurella aerogenes
Shigella dysenteriae Pasteurella multocida
Shigella flexneri Pasteurella multocida SF
Shigella sonnei P. pneumoniae/A. urea/M. haemolytica
Shigella species Pasteurella pneumotropica
Pasteurella species
SERRATIA GROUP
Serratia ficaria MISCELLANEOUS FASTIDIOUS GROUP-POS
Serratia fonticola Abiotrophia/Granulicatella species
Serratia liquefaciens Aerococcus urinae
Serratia marcescens Aerococcus viridans
Serratia odorifera 1 Erysipelothrix species
Serratia odorifera 2 Gemella haemolysans
Serratia plymuthica Gemella morbillorum
Serratia rubidaea Gemella species
Serratia species Kytococcus sedentarius
Leuconostoc spp.
SHIGELLA GROUP Listeria innocua/seeligeri
Shigella boydii Pediococcus species
Shigella boydii/dysenteriae/flexneri Rhodococcus equi
Shigella dysenteriae Rothia dentocariosa
Shigella flexneri Rothia mucilaginosa
Shigella sonnei Rothia species
Shigella species
PROTEUS GROUP
VIBRIO SPP other than V. cholerae Proteus mirabilis
Vibrio alginolyticus Proteus vulgaris
Vibrio hollisae Proteus penneri
Vibrio damsela Proteus vulgaris/penneri
Vibrio fluvialis Proteus species
Vibrio fluvialis/furnissii
Vibrio furnissii AEROMONAS SPP-GROUP
Vibrio metschnikovii Aeromonas caviae
Vibrio mimicus Aeromonas hydrophila group
Vibrio parahaemolyticus Aeromonas hydrophila
Vibrio species Aeromonas jandaei
Vibrio vulnificus Aeromonas schubertii
Aeromonas sobria
Aeromonas trota
Aeromonas veronii
Aeromonas species
9020-7493B Page 154 of 158

OTHER SPECIES GROUP

Acinetobacter lwoffii Moraxella non-liquefaciens
Actinobacillus actinomycetemcomitans Moraxella osloensis
Aeromonas caviae Psychrobacter (M.) phenypyruvicus
Aeromonas hydrophila group Moraxella species/Psychrobacter longate
Aeromonas hydrophila Neisseria elongata subsp. nitroducans
Aeromonas jandaei Ochrobactrum anthropi
Aeromonas schubertii Oligella species
Aeromonas sobria Oligella urethralis
Aeromonas trota Pasteurella aerogenes
Aeromonas veronii Mannheimia (P.) haemolytica
Aeromonas species P. pneumoniae/A. urea/M. haemolytica
Rhizobium (A.) radiobacter Pasteurella multocida
Alcaligenes species Pasteurella pneumotropica
Alcaligenes spp/Achrom xylosox/Ralstonia paucula Pasteurella species
Achromobacter xylosoxidans subsp xylosoxidans Actinobacillus (P.) ureae
Bordetella parapertussis Photorhabdus luminescens
Bordetella pertussis Plesiomonas shigelloides
Brevundimonas (P.) diminuta Pseudomonas alcaligenes
Brevundimonas (P.) vesicularis Pseudomonas alcaligenes/pseudoalcaligenes
Brevundimonas species Pseudomonas fluorescens
Burkholderia (P.) cepacia Pseudomonas fluorescens/putida
Burkholderia gladioli Pseudomonas (C.) luteola
Burkholderia pseudomallei Pseudomonas mendocina
Burkholderia species Pseudomonas (F.) oryzihabitans
Cedecea species Pseudomonas pseudoalcaligenes
Cedecea davisae Pseudomonas putida
Cedecea lapagei Pseudomonas species
Cedecea neteri Pseudomonas stutzeri
Cedecea spp 3 Pseudomonas stutzeri/mendocina
Cedecea spp 5 Ralstonia (B.) pickettii
CDC group EF-4A Roseomonas species
CDC group EF-4B Shewanella putrefaciens
CDC group EF-4B/Neisseria weaveri/N. elongata Sphingomonas (P.) paucimobilis
Chryseobacterium (F.) meningosepticum Stenotrophomonas (X.) maltophilia
Chryseobacterium species Tatumella ptyseos
Delftia (C.) acidovorans Vibrio alginolyticus
Delftia (C.) acidovorans/Comamonas testosteroni Vibrio hollisae
Comamonas testosteroni Vibrio cholerae
Edwardsiella tarda Vibrio damsela
Empedobacter (F.) brevis Vibrio fluvialis
Enterobacter asburiae Vibrio fluvialis/furnissii
Enterobacter hormaechei Vibrio furnissii
Escherichia albertii Vibrio metschnikovii
Escherichia fergusonii Vibrio mimicus
Escherichia hermanii Vibrio parahaemolyticus
Escherichia species Vibrio species
Escherichia vulneris Vibrio vulnificus
Ewingella americana Yersinia enterocolitica group
Flavobacterium species Yersinia frederiksenii
Hafnia alvei Yersinia intermedia
Kingella species Yersinia kristensenii
Klebsiella rhinoscleromatis Yersinia pestis
Kluyvera ascorbata Yersinia pseudotuberculosis
Kluyvera cryocrescens Yersinia ruckeri
Kluyvera species Yersinia species
Moraxella atlantae Yokenella regensburgei
Moraxella lacunata
9020-7493B Page 155 of 158
VIRIDANS STREPTOCOCCI GROUP MISCELLANEOUS STREPTOCOCCI GROUP

Gamma-hemolytic streptococcus Beta-hemolytic Streptococcus non-group A, non-B
Group F Streptococcus Beta-hemolytic Streptococcus non-group A
Streptococcus acidominimus Group C Streptococcus
Streptococcus anginosus/constellatus Group D Streptococcus
Streptococcus anginosus/milleri Group G Streptococcus
Streptococcus constellatus/milleri Streptococcus agalactiae (Group B)
Streptococcus equi Streptococcus agalactiae, hemolytic
Streptococcus equinis Streptococcus agalactiae, non-hemolytic
Streptococcus iniae Streptococcus bovis group
Streptococcus intermedius/milleri Streptococcus equisimilis
Streptococcus milleri group Streptococcus equi/equisimilis
Streptococcus mitis group Streptococcus equisimilis
Streptococcus mitis Streptococcus species
Streptococcus mitis/oralis Streptococcus zooepidemicus
Streptococcus mutans Viridans streptococcus
Streptococcus parasanguis
Streptococcus salivarius GROUP A STREPTOCOCCUS GROUP
Streptococcus sanguis Streptococcus pyogenes
Streptococcus sanguis II Group A Streptococcus
Streptococcus uberis
Streptococcus species ENTEROCOCCUS GROUP (for Dried-Overnight gram-
positive panels)
Viridans streptococcus Enterococcus avium
Viridans streptococcus group Enterococcus casseliflavus
Enterococcus durans
BETA-HEMOLYTIC STREPTOCOCCI GROUP Enterococcus durans/hirae
Beta-hemolytic Streptococcus non-Group A, non-B Enterococcus faecalis
Beta-hemolytic Streptococcus non-Group A Enterococcus faecium
Group A Streptococcus Enterococcus faecium group
Group C Streptococcus Enterococcus gallinarum
Group G Streptococcus Enterococcus hirae
Group C/G Streptococcus Enterococcus mundtii
Streptococcus agalactiae (Group B) Enterococcus raffinosus
Streptococcus agalactiae, hemolytic Enterococcus species
Streptococcus agalactiae, non-hemolytic
Streptococcus equisimilis ENTEROCOCCUS GROUP (for SYNERGIES PLUS®
Streptococcus pyogenes (Group A) gram-positive panels)
Streptococcus species Enterococcus avium
Streptococcus zooepidemicus Enterococcus casseliflavus
Enterococcus durans
Enterococcus durans/hirae
Enterococcus faecalis
Enterococcus faecium
Enterococcus faecium group
Enterococcus gallinarum
Enterococcus hirae
Enterococcus mundtii
Enterococcus raffinosus
Enterococcus species
9020-7493B Page 156 of 158

COAGULASE NEGATIVE STAPHYLOCOCCI GROUP

Macrococcus caseolyticus
Staphylococcus arlettae
Staphylococcus auricularis
Staphylococcus capitis
Staphylococcus capitis-capit
Staphylococcus capitis-ureo
Staphylococcus caprae
Staphylococcus carnosus
Staphylococcus chromogenes
Staphylococcus cohnii
Staphylococcus cohnii-cohnii
Staphylococcus cohnii-urea
Staphylococcus epidermidis
Staphylococcus equorum
Staphylococcus gallinarum
Staphylococcus haemolyticus
Staphylococcus hominis
Staphylococcus hominis-hominis
Staphylococcus hominis-novo
Staphylococcus hyicus
Staphylococcus hyicus/chromo
Staphylococcus intermedius
Staphylococcus kloosii
Staphylococcus lentus
Staphylococcus lugdunensis
Staphylococcus saprophyticus
Staphylococcus schleiferi
Staphylococcus schleiferi coagulans
Staphylococcus schleiferi schleiferi
Staphylococcus sciuri
Staphylococcus simulans
Staphylococcus species
Staphylococcus warneri
Staphylococcus xylosus
Coagulase Negative Staphylococci
9020-7493B Page 157 of 158

Specific Classification for Panel Groups
EUCAST Panel Class- French panels EUCAST Panel Class – French panels
Dried Overnight Gram Negative Dried Overnight Gram Positive
Neg Combo 48 (NC48) Pos Combo 30 (PC30)
Neg MIC 39 (NM39) Pos Strep Combo 36 (PC36)
Neg Urine Combo 57 (NUC57) Pos MIC 31 (PM31)
EUCAST Blended Panel Class- EUCAST Blended Panel Class –

Dried Overnight Gram Negative Dried Overnight Gram Positive
Neg Breakpoint Combo 45 (NBC45) Pos Breakpoint Combo 32 (PBC32)
Neg Breakpoint Combo 46 (NBC46) Pos Breakpoint Combo 33 (PBC33)
Neg Breakpoint Combo 49E (NBC49E) Pos Combo 35 (PC35)
Neg Entero Combo 70 (NC70) Pos Combo 42 (PC42)
Neg Non Entero Combo 71 (NC71) Pos MIC 32 (PM32)
Neg MIC 40 (NM40) Pos MIC 33 (PM33)
Neg MIC 44 (NM44)
Neg Urine Combo 56 (NUC56)
Neg Urine Combo 59 (NBC59)
Neg Urine Combo 69 (NBC69)
EUCAST Blended Panel Class- ANVISA Panel Class –

Dried MICroSTREP Dried Overnight Gram Negative*
MICroSTREP plus 6 (MSP6) Neg Combo 66
* NC66 uses primarily ANVISA for cephalosporins and
CLSI for everything else.
9020-7493B Page 158 of 158

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Adult Therapy

Siemens Healthcare Diagnostics Inc.

 2013 Siemens Healthcare Diagnostics Inc.

9020-7493B Page 2 of 158

Revision Record ........................................................................................................................................................ 5

General Notes for Reporting Results: ..................................................................................................................... 6

Extreme Caution from the CLSI M100-S22: ........................................................................................................... 8

Use of Inducible Beta-Lactamase Flag:................................................................................................................... 8

Cefoxitin Screen: ....................................................................................................................................................... 9

Inducible Clindamycin: ............................................................................................................................................. 9

Streptococci Reporting (Viridans, Beta-hemolytic and S. pneumoniae): .......................................................... 10

Streptococci Limitations: ....................................................................................................................................... 10

Miscellaneous Fastidious Organism Limitation: .................................................................................................. 10

Miscellaneous Organism Recommendation: ........................................................................................................ 10

Synergies Screen Reporting: ................................................................................................................................. 10

Predicted Susceptibility Rules for Synergies plus Pos Panels: ......................................................................... 11

Extended Spectrum Beta-Lactamase (ESBL) Interpretations: ........................................................................... 12

ANTIMICROBIAL AGENT THERAPY GUIDE TABLES .......................................................................................... 15

9020-7493B Page 3 of 158

9020-7493B Page 4 of 158

9020-7493B Page 5 of 158

Synergies plus® Gram Negative panels:

Synergies plus® Gram Positive panels:

Referenced from the CLSI M100-S22

9020-7493B Page 6 of 158

• MIC values are reported in µg/ml or mg/l.

Urine/Systemic Therapy Interpretation Rules:

Warning from the CLSI M100-S22:

agents administered by oral route only

Use of Inducible Beta-Lactamase Flag:

Possible inducible beta-lactamase producing organisms:

Beta-lactam antimicrobial agents for inducible beta-lactamase flag:

9020-7493B Page 8 of 158

Tests Negative Positive

9020-7493B Page 9 of 158

Miscellaneous Fastidious Organism Limitation:

Miscellaneous Organism Recommendation:

Synergy Screen Reporting

Gentamicin Synergy Screen Streptomycin Synergy Kanamycin Synergy

9020-7493B Page 10 of 158

Antimicrobial Antimicrobial Antimicrobial Agent If If If Penicillin-S or R

9020-7493B Page 11 of 158

9020-7493B Page 12 of 158

9020-7493B Page 13 of 158

Interpretations Reported as S, I or R for the following Antimicrobial Agents:

9020-7493B Page 14 of 158

DRIED OVERNIGHT AND RAPID (FLUOROGENIC) GRAM-NEGATIVE PANELS

Amikacin MIC ENTEROBACTERIACEAE NON- ACINETOBACTER SPP. PSEUDOMONAS

Amikacin MIC ENTEROBACTERIACEAE NON- ACINETOBACTER SPP. PSEUDOMONAS

Amikacin (Ak) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS

9020-7493B Page 15 of 158

Amikacin (Ak) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

Amikacin (Ak) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

Amoxicillin (Amx) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. .

Amoxicillin / MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP.

9020-7493B Page 16 of 158

Amoxicillin / MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA

Ampicillin (Am) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP. V. CHOLERAE

Ampicillin (Am) MIC ENTEROBACTERIACEAE ACINETOBACTER SPP. PSEUDOMONAS SPP. V. CHOLERAE

Ampicillin (Am) MIC ENTEROBACTERIACEAE NON- P. AERUGINOSA V. CHOLERAE

9020-7493B Page 17 of 158

Ampicillin (Am) MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE P. AERUGINOSA V. CHOLERAE

Ampicillin-Sulbactam MIC ENTEROBACTERIACEAE NON-ENTEROBACTERIACEAE PSEUDOMONAS SPP.