VITEK® 2 and Etest® Merger - bioMerieux

VITEK ® 2 and Etest ® Merger
The Synergistic Merger of Two Innovative Antimicrobial Susceptibility Test Methods
bioMérieux’s acquisition of AB BIODISK and their
leading product line, Etest ® , brings together two
of the most innovative, progressive, accurate
and clinically relevant susceptibility testing
methodologies in the microbiology world.
VITEK ® 2 automation provides same-day,
clinically relevant identification and susceptibility
test results for the majority of organisms
encountered in the laboratory. Microbiologists
and clinicians have made VITEK 2 the leading
automated Identification and Antibiotic
Susceptibility Testing (ID/AST) instrument in the
world today.
The synergy between the VITEK 2 and Etest
is overwhelming. Used together, the VITEK 2
and Etest meet all of the susceptibility testing
requirements of a routine clinical microbiology
laboratory. Currently, laboratories striving for
LEAN management utilize these methods, and
these methods alone, to streamline laboratory
operations. The many benefits of the synergy
between VITEK 2 and Etest include:
• Better Antibiotic Stewardship
• Improved Financial Performance for
Healthcare Institutions
• Quantitative MIC for All Patients
• Improved Patient Outcomes
VITEK 2’s ability to provide same-day reporting
of results has documented benefits in positively
impacting clinical outcomes and reducing the
cost of patient care . In order to make critical
therapeutic decisions as quickly as possible,
clinicians need ID/AST information as rapidly as
technically feasible. Microbiology laboratories
must implement procedures that decrease
the time from specimen collection to clinically
available results. Decreasing turn-around-time
allows physicians to prescribe optimal antibiotic
therapy and, equally important, to discontinue
unnecessary empiric therapy. Optimizing therapy
and reducing unnecessary therapy is especially
important today as good antibiotic stewardship
is a necessity and not a luxury. Steps to control
emerging antibiotic resistance are crucial in the
war against infectious diseases. Every measure
must be taken in this effort, including the
laboratory’s role in providing physicians with ID/
AST results as soon as possible. Rapid reporting
of ID/AST results has been shown to decrease
hospital length-of-stay and this, no doubt,
lessens one’s chance of developing a healthcare
associated infection.
Microbiologists need labor saving automation
to increase laboratory productivity. The critical
shortage of highly qualified microbiologists
and clinical laboratory scientists is fueling this
need for automating those procedures that
can be automated. This shortage, coupled with
the impending retirement of “baby boomer”
technologists, mandates automation wherever
possible. VITEK 2 addresses this need for
additional automation in two ways:
1) The “front-end” automation on the VITEK 2
reduces manual steps and has been shown in
independent studies to reduce technologist set-up
1, 2
time in comparison to other ID/AST systems.
2) The Advanced Expert System (AES)
validates every susceptibility test result
sent to clinicians and flags results that may
be atypical or erroneous. This allows the
microbiologist reviewing ID/AST reports to
focus attention specifically on results that may
require further attention.
These labor saving features minimize handson
time for technologists and accelerates the
review process for supervisors and directors.
Laboratories can then utilize time, their most
valuable resource, more effectively.
Ideally, all ID/AST results would be reported the
same day tests are set up. There are situations,
however, when this is not possible. These
situations include:
• Organisms that, for various reasons, are not
candidates for rapid ID/AST methods
• New antimicrobial agents introduced for
patient care before they are available for
testing on automated ID/AST instruments
• Changes in FDA or CLSI breakpoints that
result in a lag period before the automated ID/
AST instruments can release software updates
to accommodate the new breakpoints
These situations demonstrate the perfect
synergy between VITEK 2 and Etest. Etest
provides MICs for slow-growing and
fastidious organisms that have unique growth
requirements and cannot be tested by
automated methods. Etest enables flexibility in
testing new antimicrobial agents and facilitates
reporting even when breakpoints change.
Etest and VITEK 2 both provide minimum
inhibitory concentration (MIC) results. The MIC
is the lowest concentration of an antimicrobial
agent required to prevent the growth of
a microorganism. MIC results provide a
quantitative measure of a microorganism’s
susceptibility. MIC results form the basis for the
categorization of organisms into the categories
of Susceptible (S), Intermediate (I) or Resistant
(R). The VITEK 2 is a broth microdilution method
and the Etest is a predefined antibiotic gradient
method. Both provide MIC results but utilize
different methodologies.
There are laboratories that choose to report only
the S, I and R category results. These laboratories
do not report the quantitative MIC. There are
situations, however, when clinical outcomes may
be improved by providing clinicians with MIC as
well as category data. It may be advantageous
in these situations for a clinician to know if
the organism is testing at the lower end of the
susceptible range or at the higher end of that
range. This knowledge may impact the choice of
antimicrobial agent or the dosage of the chosen
antimicrobial. Clinical priorities for MIC testing
include:
• Sterile site infections (e.g., endocarditis)
• Serious nosocomial infections
• Chronic infections (e.g., cystic fibrosis)
• ICU or other high-risk patients
• Immune suppressed patients
Etest is a “ready to use” reagent strip with a
predefined gradient of antibiotic. The gradient
covers a continuous MIC range corresponding
to 15 two-fold dilutions with a precision of 0.5 /
dilution. This methodology allows for testing of
a wide variety of antimicrobial agents, which are
accurately immobilized on a calibrated plastic
strip. This allows Etest to:
• Handle “difficult” drugs
• Detect phenotypic resistance
• Provide on-scale accurate MIC results

Many laboratories employ disk diffusion as
their primary AST method or use this for
backup testing of their automated system.
However, there are disadvantages to employing
disk diffusion testing. The most important
drawback is the inability of disk diffusion to
provide a quantitative MIC result. As has been
stated above, the reporting of an MIC result
can be crucial information in a number of
clinical situations. Additionally, disk diffusion is
unsuitable for testing large molecules such as
vancomycin and for some “difficult” drugs such
as daptomycin.
Etest is an agar-based method, like disk diffusion,
but it provides a wide range of concentrations for
With the acquisition of AB BIODISK, many
questions will arise regarding service and support
of the Etest product line through bioMérieux. The
following is a list of answers to questions that
you may have as we integrate the Etest product
line into bioMérieux.
bioMérieux is working hard to make the integration
of the Etest product line as smooth as possible and
to provide you with the same high level of service
to which you are accustomed. We will also provide
further communication, either through your sales
representative or via our web site.
Q) How will I place orders for Etest reagents?
A) You may continue placing orders as you
always have with AB BIODISK.
- Fax your purchase order to 732-457-8980.
- Alternately you may fax your purchase
order using bioMérieux’s toll free fax
number at 800-432-9682.
- For ordering assistance, you may call the
former AB BIODISK toll free support line
at 800-874-8814. Alternately, you may
call bioMérieux’s toll free support line at
800-682-2666. In either case, listen for and
select prompt number two, after which you
will be connected to a bioMérieux order
fulfillment professional who will be happy
to assist you with your order.
Q) Who do I contact for Etest
Technical Support?
A) You may continue using the former
AB BIODISK toll free support line at
800-874-8814. Alternately, you may call
bioMérieux’s toll free support line at
800-682-2666. In either case, listen for and
select prompt number three for Reagent
Technical Support, then prompt number six
for Etest support. A bioMérieux Technical
Support Specialist will be happy to assist
you with your inquiry.
reporting MIC results. This provides the benefits
of utilizing a broth microdilution method for
primary testing of routine organisms and an agar
based method with MIC reporting capabilities for
backup testing and for “special situation” testing.
Etest also lends itself well to testing fastidious
organisms as a variety of agar, supplements,
incubation and Inocula can be employed for
these organisms. Applications for Etest stretch
from robust aerobes to anaerobes, pneumococci,
meningococci and to extremely fastidious
organisms such as the HACEK group, Bordatella
and Francisella.
More than 700 studies have been published
in peer-reviewed journals that validate the
Frequently Asked Questions
Q) What are the commercial addresses
for bioMérieux?
A) Corporate Offices:
bioMérieux, Inc.
100 Rodolphe Street
Durham, NC 27712
For Mailing of Checks:
bioMerieux, Inc.
PO Box 500308
St Louis, MO 63150-0308
For Express Mailing of Checks:
Bank of America
Lockbox Services (500308)
800 Market Street
St Louis, MO 63101
ForACH/EDI Payments:
Bank of America, St Louis MO
ABA ROUTING#: 081000032
Account No. 100101206780
For Wires:
Bank of America, St Louis MO
SWIFT CODE: BOFAUS3N
(For Wires in US Dollars)
SWIFT CODE: BOFAUS6S
(For Wires in Foreign Currency)
ABA ROUTING#: 0260-0959-3
Account No. 100101206780
• bioMérieux Inc Federal Tax ID # 43-1109770,
DUNS# 08-678-5110
• For questions regarding payment, please call
the Credit Department at:
• 1-800-682-2666, select prompt number five.
Web Site:
www.bioMerieux.com
www.bioMerieux-usa.com
precision and accuracy of the Etest method. The
interpretation of MIC results is distinct and clearcut
for the vast majority of organisms tested.
For more information about how the VITEK 2
Etest synergy can benefit your laboratory, please
contact your bioMérieux representative.
The LEAN solution of VITEK 2 and Etest
addresses the emerging challenges facing
healthcare today.
1. J. Ayats et al, Analysis of the Impact of Using a VITEK 2 COMPACT ®
System in a Clinical Microbiology Laboratory: Comparison with the
MicroScan WalkAway System ® , American Society for Microbiology,
June 2008
2. W. Rommler et al, Analysis of the Compartative Workflow and
ID/AST Result of the VITEK 2 Compact and the Phoenix System,
American Society for Microbiology, May 2006
Q) Will I keep the same product numbers?
A) The AB BIODISK product numbers have
been converted to bioMérieux product
numbers. A cross-reference table is
included below to aid in making the
transition.
Q) Will my ABB sales representative change?
A) You will continue to correspond with your
current sales representative until further
notice from bioMérieux.
Q) Will my current freight terms change?
A) Freight terms will become consistent
with the current business practices of
bioMérieux.
Q) Will bioMérieux honor my existing
pricing agreements?
A) Yes, pricing agreements in effect with AB
BIODISK will be honored by bioMérieux.
Q) Will I be able to access www.abbiodisk.com
for technical documents?
A) Yes, the AB BIODISK web site will remain
operational until October 30th of 2008.
After that time, all the related Etest material
and reference documents will be posted on
www.biomerieux-usa.com.

The following cross-reference guide correlates AB BIODISK product numbers with the corresponding bioMérieux product
numbers. Going forward, please use the bioMérieux product numbers when placing an order. We apologize for any
inconvenience this change may cause your facility. Thank you in advance for incorporating these changes into your systems.
bioMérieux
Product
Number
AB BIODISK
Product
Number
Product Description
501358 51100138 AMIKACIN AK 256 F100
501350 51100130 AMIKACIN AK 257 F30
501058 51100108 AMOXI/CLAV 2/1 XL 256 F100
501050 51100100 AMOXI/CLAV 2/1 XL 256 F30
500958 51100098 AMOXICILLIN AC 256 F100
500950 51100090 AMOXICILLIN AC 256 F30
537148 51003718 AmpC CN/CNI 32/32 B100
537140 51003710 AmpC CN/CNI 32/32 B30
526348 51002638
AMPHOTERICIN-B AP 32
B100
526340 51002630 AMPHOTERICIN-B AP 32 B30
501858 51100188 AMPICIL/SULB 2/1 AB 256 F100
501850 51100180 AMPICIL/SULB 2/1 AB 256 F30
501558 51100158 AMPICILLIN AM 256 F100
501550 51100150 AMPICILLIN AM 256 F30
532048 51003208 ANIDULAFUNGIN AND 32 B100
532040 51003200 ANIDULAFUNGIN AND 32 B30
501658 51100168 AZITHROMYCIN AZ 256 F100
501650 51100160 AZITHROMYCIN AZ 256 F30
501758 51100178 AZTREONAM AT 256 F100
501750 51100170 AZTREONAM AT 256 F30
528648 51002868 BACITRACIN BA 256 B100
528640 51002860 BACITRACIN BA 256 B30
502558 51100258
BENZYLPENICILLIN PG 256
F100
502550 51100250 BENZYLPENICILLIN PG 256 F30
502658 51100268
BENZYLPENICILLIN PGL 32
F100
502650 51100260 BENZYLPENICILLIN PGL 32 F30
532448 51003248 CASPOFUNGIN CS 32 B100
532440 51003240 CASPOFUNGIN CS 32 B30
504558 51100458 CEFACLOR CF 256 F100
504550 51100450 CEFACLOR CF 256 F30
505058 51100508 CEFEPIME PM 256 F100
505050 51100500 CEFEPIME PM 256 F30
529948 51002998 CEFIXIME IX 256 B100
529940 51002990 CEFIXIME IX 256 B30
529348 51002938
529340 51002930
CEFOPERA/SULB 2/1 CPS 256
B100
CEFOPERA/SULB 2/1 CPS
256 B30
505558 51100558 CEFOTAXIME CT 256 F100
505550 51100550 CEFOTAXIME CT 256 F30
505658 51100568 CEFOTAXIME CTL 32 F100
505650 51100560 CEFOTAXIME CTL 32 F30
506348 51000638 CEFOTETAN CN 256 B100
506350 51100630 CEFOTETAN CN 256 F30
506558 51100658 CEFOXITIN FX 256 F100
506550 51100650 CEFOXITIN FX 256 F30
506448 51000648 CEFPIROME CR 256 B100
506440 51000640 CEFPIROME CR 256 B30
505848 51000588 CEFPODOXIME PX 256 B100
505840 51000580 CEFPODOXIME PX 256 B30
506758 51100678 CEFTAZIDIME TZ 256 F100
506750 51100670 CEFTAZIDIME TZ 256 F30
527340 51002730 CEFTIZOXIME CZ 32 B30
527348 51002738 CEFTIZOXIME CZ 32 B100
506658 51100668 CEFTRIAXONE TX 256 F100
506650 51100660 CEFTRIAXONE TX 256 F30
507058 51100708 CEFTRIAXONE TXL 32 F100
* F30/F100 - Foil Package
* B30/B100 - Blister Package
bioMérieux
Product
Number
AB BIODISK
Product
Number
Product Description
507050 51100700 CEFTRIAXONE TXL 32 F30
506958 51100698 CEFUROXIME XM 256 F100
506950 51100690 CEFUROXIME XM 256 F30
503558 51100358 CEPHALOTHIN CE 256 F100
503550 51100350 CEPHALOTHIN CE 256 F30
507558 51100758
507550 51100750
CHLORAMPHENICOL CL
256 F100
CHLORAMPHENICOL CL
256 F30
508658 51100868 CIPROFLOXACIN CI 32 F100
508650 51100860 CIPROFLOXACIN CI 32 F30
508748 51000878
508740 51000870
509558 51100958
CLARITHROMYCIN CH 256
B100
CLARITHROMYCIN CH 256
B30
CLINDAMYCIN CM 256
F100
509550 51100950 CLINDAMYCIN CM 256 F30
537348 51003738 COLISTIN CO 256 B100
537340 51003730 COLISTIN CO 256 B30
535058 51103508 DAPTOMYCIN DPC 256 F100
535050 51103500 DAPTOMYCIN DPC 256 F30
509748 51000978 DOXYCYCLINE DC 256 B100
509740 51000970 DOXYCYCLINE DC 256 B30
528948 51002898 ENROFLOXACIN EF 32 B100
528940 51002890 ENROFLOXACIN EF 32 B30
531658 51103168 ERTAPENEM ETP 32 F100
531650 51103160 ERTAPENEM ETP 32 F30
510558 51101058
ERYTHROMYCIN EM 256
F100
510550 51101050 ERYTHROMYCIN EM 256 F30
532240 51003220 ESBL CT/CTL 16/1 B30
532248 51003228 ESBL CT/CTL 16/1 B100
534748 51003478 ESBL PM/PML 16/4 B100
534740 51003470 ESBL PM/PML 16/4 B30
532540 51003250 ESBL TZ/TZL 32/4 B30
532548 51003258 ESBL TZ/TZL 32/4 B100
527740 51002770 ETHAMBUTOL EB 256 B30
527540 51002750 ETHIONAMIDE ET 256 B30
510858 51101088
FLUCONAZOLE FL 256
F100
510850 51101080 FLUCONAZOLE FL 256 F30
510950 51101090 FLUCYTOSINE FC 32 F30
510958 51101098 FLUCYTOSINE FC 32 F100
529140 51002910 FOSFOMYCIN FM 1024 B30
529148 51002918
FOSFOMYCIN FM 1024
B100
511548 51001158 FUSIDIC-ACID FU 256 B100
511540 51001150 FUSIDIC-ACID FU 256 B30
530258 51103028 GATIFLOXACIN GA 32 F100
530250 51103020 GATIFLOXACIN GA 32 F30
530358 51103038 GEMIFLOXACIN GEM 32 F100
530350 51103030 GEMIFLOXACIN GEM 32 F30
512740 51001270
512558 51101258
GENTAMICIN GM 1024
B30
GENTAMICIN GM 256
F100
512550 51101250 GENTAMICIN GM 256 F30
512748 51001278
GENTAMICIN GM 1024
B100
537248 51003728 GRD VA/TP 32/32 B100
537240 51003720 GRD VA/TP 32/32 B30
513658 51101368 IMIPENEM IP 32 F100
bioMérieux
Product
Number
AB BIODISK
Product
Number
Product Description
513650 51101360 IMIPENEM IP 32 F30
527940 51002790 ISONIAZIDE IZ 256 B30
525858 51102588 ITRACONAZOLE IT 32 F100
525850 51102580 ITRACONAZOLE IT 32 F30
527848 51002788 KANAMYCIN KM 256 B100
527840 51002780 KANAMYCIN KM 256 B30
525948 51002598
525940 51002590
KETOCONAZOLE KE 32
B100
KETOCONAZOLE KE 32
B30
527458 51102748 LEVOFLOXACIN LE 32 F100
527450 51102740 LEVOFLOXACIN LE 32 F30
531358 51103138 LINEZOLID LZ 256 F100
531350 51103130 LINEZOLID LZ 256 F30
534248 51003428 MBL IP/IPI 256/64 B100
534240 51003420 MBL IP/IPI 256/64 B30
513858 51101388
MEROPENEM MP 32
F100
513850 51101380 MEROPENEM MP 32 F30
530058 51103008
530050 51103000
516058 51101608
METRONIDAZOLE MZH
256 F100
METRONIDAZOLE MZH
256 F30
MINOCYCLINE MC 256
F100
516050 51101600 MINOCYCLINE MC 256 F30
529058 51102908
MOXIFLOXACIN MX 32
F100
529050 51102900 MOXIFLOXACIN MX 32 F30
516348 51001638
MUPIROCIN MU 1024
B100
516340 51001630 MUPIROCIN MU 1024 B30
516548 51001658 NALIDIXIC-ACID NA 256 B100
516540 51001650 NALIDIXIC-ACID NA 256 B30
517548 51001758 NETILMICIN NC 256 B100
517540 51001750 NETILMICIN NC 256 B30
530448 51003048
530440 51003040
519548 51001958
NITROFURANTOIN NI 512
B100
NITROFURANTOIN NI 512
B30
NORFLOXACIN NX 256
B100
519540 51001950 NORFLOXACIN NX 256 B30
519658 51101968 OFLOXACIN OF 32 F100
519650 51101960 OFLOXACIN OF 32 F30
520558 51102058 OXACILLIN OX 256 F100
520550 51102050 OXACILLIN OX 256 F30
521458 51102148
PIP/TAZO/CON-4 PTC 256
F100
521450 51102140 PIP/TAZO/CON-4 PTC 256 F30
521558 51102158 PIPERACILLIN PP 256 F100
521550 51102150 PIPERACILLIN PP 256 F30
533448 51003348 POLYMYXIN B PO 1024 B100
533440 51003340 POLYMYXIN B PO 1024 B30
532148 51003218
532140 51003210
528758 51102878
528750 51102870
POSACONAZOLE POS 32
B100
POSACONAZOLE POS
32 B30
QUINUPRI/DALFOPRI QDA
32 F100
QUINUPRI/DALFOPRI QDA
32 F30
526058 51102608 RIFAMPICIN RI 32 F100
526050 51102600 RIFAMPICIN RI 32 F30
529248 51002928
SPECTINOMYCIN SC 1024
B100

ioMérieux
Product
Number
AB BIODISK
Product
Number
529240 51002920
526848 51002688
526840 51002680
535148 51003518
Product Description
SPECTINOMYCIN SC 1024
B30
STREPTOMYCIN SM 1024
B100
STREPTOMYCIN SM 1024
B30
SULBACTAM SUL 256
B100
535140 51003510 SULBACTAM SUL 256 B30
534148 51003418
534140 51003410
SULFAMETHOXAZOLE SX
1024 B100
SULFAMETHOXAZOLE SX
1024 B30
522048 51002208 TEICOPLANIN TP 256 B100
522040 51002200 TEICOPLANIN TP 256 B30
535648 51003568 TEMOCILLIN TMO 1024 B100
535640 51003560 TEMOCILLIN TMO 1024 B30
522558 51102258 TETRACYCLINE TC 256 F100
522550 51102250 TETRACYCLINE TC 256 F30
522658 51102268
522650 51102260
TICAR/CLAV-CON-2 TLC 256
F100
TICAR/CLAV-CON-2 TLC
256 F30
533558 51103358 TIGECYCLINE TGC 256 F100
533550 51103350 TIGECYCLINE TGC 256 F30
522748 51002278
TOBRAMYCIN TM 256
B100
522740 51002270 TOBRAMYCIN TM 256 B30
533148 51003318
TOBRAMYCIN TM 1024
B100
533140 51003310 TOBRAMYCIN TM 1024 B30
524458 51102448 TRIM/SULFA 1/19 TS 32 F100
bioMérieux, Inc.
100 Rodolphe Street
Durham, NC 27712
bioMérieux
Product
Number
AB BIODISK
Product
Number
Product Description
524450 51102440 TRIM/SULFA 1/19 TS 32 F30
523658 51102368 TRIMETHOPRIM TR 32 F100
523650 51102360 TRIMETHOPRIM TR 32 F30
525558 51102558 VANCOMYCIN VA 256 F100
525550 51102550 VANCOMYCIN VA 256 F30
532848 51003288
VORICONAZOLE VO 32
B100
532840 51003280 VORICONAZOLE VO 32 B30
559802 51005982 APPLICATOR SIMPLEX C76
559803 51005983 INOCULATOR RETRO C80
559804 51005984 VACUUM PEN NEMA C88
5100700700 51007007 BIOTOOLS AC ADAPTOR
5100700600 51007006
5100700300 51007003
5100700200 51007002
BIOTOOLS O RING FOR PLATE
HOLDER
BIOTOOLS PLATE HOLDER
150mm
BIOTOOLS PLATE HOLDER
90mm
5100700800 51007008 BIOTOOLS PLATE HOLDER PINS
5100700000 51007000
BIOTOOLS POWER CABLE
(EUROPE)
5100700100 51007001 BIOTOOLS POWER CABLE (US)
559906 51005996 CLAMP FOC
559809 51005989 CLAMPS 5-PACK
559709 51005979 DESICCANT CAPSULES 8 PCS
559909 51005999 ETEST APPLICATOR-KIT
559806 51005986 ETEST APPLICATOR TAPE
559807 51005987 ETEST APPLICATOR+TEJP
5M0163 M0000163 ETEST STORAGE CONTAINER
559808 51005988 MANUAL APPLICATOR+TAPE
bioMérieux
Product
Number
AB BIODISK
Product
Number
Product Description
559904 51005994 MEASURING STICK 5-PACK
559905 51005995 MEASURING STICK FOC
559907 51005997 MEASURING STICK FOC USA
5100700500 51007005 NEMA C88 VACUUM PEN KIT
5100700400 51007004
559801 51005981
SIMPLEX C76 CARTRIDGE
HOLDER
STORAGE BOX MAXI W/
CARTRIDGE
559902 51005992 STORAGE BOX MAXI
559708 51005978
STORAGE BOX MIDI W/
CARTRIDGE
559901 51005991 STORAGE BOX MIDI
559800 51005980
STORAGE BOX MINI W/
CARTRIDGE
559900 51005990 STORAGE BOX MINI
5100599300 51005993
SUCTION CUPS FOR NEMA C88
& SIMPLEX C76 (two units)