Changing MIC Breakpoints: Do Mechanisms Count

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Treatment of ESBL Positive Organisms with Cephalosporins <strong>MIC</strong> FAILURE DEATH 8 100% (6/6) 33% (2/6) 4 67% (2/3) 0% (0/3) 2 33% (1/3) 0% (0/3) ≤1 27% (3/11) 18% (2/11) (CLSI breakpoint 8 g/ml) Paterson, DL, et al. JCM 39: 2206 – 2212, 2001 10
New CLSI Guidelines 2010 • Problem with this approach Clinical studies show patients with “susceptible” <strong>MIC</strong>s + ESBL fail therapy Inoculum used in bmd (10 5 ) too low and may dilute out resistant subpopulations giving false susceptible results 11
Page 1 and 2: Changing MIC Breakpoints: Do Mechan
Page 3 and 4: • The major issue is whether the
Page 5 and 6: CLSI Guidelines Staph spp. Table 2
Page 7 and 8: New CLSI Guidelines 2010 • This d
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Page 34 and 35: Why labs should continue to perform
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Changing MIC Breakpoints: Do Mechanisms Count

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