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Etest Reading
AB bioMrieux 2008
Etest Reading
Organism specific
Resistance mechanisms
Etest Reading Guides (ERG 001, 002) Customer Information Sheets (CIS 006, CIS 007) Etest Technical Guide (ETG 006) Mycobacteria
Molecule Size
Between Markings
Is it a sharp endpoint?
YES: then read MIC where growth intersects the strip. VA, MIC 1.0 g/mL
Is it a sharp endpoint?
cidal
static
Macrocolonies
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Isoniazide Aminoglycosides
Quinolones
Metronidazole Rifampicin
Ethambutol
Glycopeptides Fosfomycin
Amphotericin B
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Pneumo - Pen G
Obtain good confluent growth Look for microcolonies and hazes MIC: 4.0 g/mL
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Induction of regrowth at higher concentrations of the antimicrobial Read the highest value
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Bacteriostatic Drugs
Read at 80% inhibition i.e. first point of significant change as judged by the naked eye (CIS 007).
Lincomycins
Chloramphenicol Sulfonamides Trimethoprim
Macrolides
Azoles
Echinocandins
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Linezolid
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Pipercillin/tazobactam
Ticarcillin/clavulanic acid Ignore the inhibition of growth caused by the activity of the inhibitor (tazobactam, clavulanic acid) and extrapolate the ellipse to give the MIC of pipercillin or ticarcillin.
Echinocandins
Distorted ellipse
ESBL POSITIVE
Report:
ESBL producer and resistant to all penicillins, Cephalosporins and aztreonam (CLSI M100-S series).
TZ 1 and TZ/TZL 8
or
Phantom
ESBL
ESBL +
Categorisation of S, I, R
Use MIC breakpoints from most recent CLSI M100-S or own regulatory body (eg. EUCAST,BSAC) If not available, consult the literature Etest gives values in-between 2-fold dilutions
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R I S
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Technical Documents
AB bioMrieux 2008
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