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Changing MIC Breakpoints: Do Mechanisms Count

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New CLSI Guidelines 2010<br />

• Problem with this approach<br />

Clinical studies show patients with “susceptible” <strong>MIC</strong>s + ESBL<br />

fail therapy<br />

Inoculum used in bmd (10 5 ) too low and may dilute out resistant<br />

subpopulations giving false susceptible results<br />

Different susceptibility testing methods give varying results<br />

<strong>MIC</strong> results are not reproducible and can very up to<br />

>3 dilutions upon repeat testing<br />

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