30 Aug Buy CLSI M45 A2 Ed. 2 () Methods For Antimicrobial Dilution And Disk Susceptibility Testing Of Infrequently Isolated Or Fastidious. 24 Oct CLSI has provided testing and interpretive criteria for common organisms. • Labs occasionally need to test “infrequently isolated or fastidious”. Fastidious Organisms: CLSI MA2 update. Diane M. Citron. SWACM, R.M. Alden Research Lab. Culver City, CA. History. ▫ CLSI has provided testing.

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Receive exclusive offers and updates clei Oxford Academic. This guideline is based somewhat on standardized procedures in other documents, but contains specific instructions on when and how to perform antimicrobial susceptibility testing of fastidious or infrequently isolated organisms that might be resistant to therapy commonly prescribed through antibiotics.

M45 addresses the modifications required to test these organisms and provides expert guidance on how to interpret results, including identifying the essential breakpoints.

CLSI is a global, nonprofit organization that promotes the development and use of voluntary consensus standards and guidelines within the clsii care community. Close mobile search navigation Article navigation.

Jorgensen offers an example of how this guideline might be used in a typical laboratory.

Oxford University Press is a department of the University of Oxford. Email alerts New issue alert. Working group member Paul C. For some of the organisms, a disk diffusion method is described, and this k45-a2 can be easily adopted by most clinical laboratories performing disk diffusion testing.

Jorgenson stresses the importance of understanding their distinction from M Related articles in Google Scholar. Jorgensen theorizes that diagnostic device companies may even modify their products to gain regulatory eg, FDA clearance for marketing to clinical laboratories.


The methods described are generic reference methods that can be used for routine susceptibility testing by mm45-a2 clinical laboratories.

Jorgensen and Hindler both agree that this revised guideline is very timely, in light of the increasingly cli challenges faced by laboratories performing susceptibility testing on these organisms, including increased pressure from clinicians to provide susceptibility data quickly, and the need for reliable methods to identify emerging resistance.

However, in cases such as those involving fastidious and infrequently isolated organisms for which specific guidelines do not exist, ,45-a2 have resorted to various alternative methods and applied breakpoints j45-a2 other groups of organisms.

Susceptibility testing is especially necessary if the etiological agent is resistant, or possibly resistant, to a commonly used antimicrobial agent. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. However, clinicians need m45-a22 guidance on treating organisms that can cause serious, life-threatening infections eg, bacteremia, endocarditis, and meningitis.

However, there are instances in which the sensitivity of such a pathogen cannot be predicted simply based on the identity of the organism. Therefore, laboratories need specific guidelines on how to perform valid susceptibility testing without using the US Food and Drug Administration FDA -cleared instrumentation and commercial test systems found in most laboratories. Jorgensen, PhD, chairholder of the CLSI working group that developed the document, it has long been accepted that for the most effective management of bacterial infections, laboratories must be cldi to determine susceptibility or resistance to therapeutic agents.

M45 does not suggest that laboratories test all infrequently encountered or fastidious isolates, especially if they are of dubious clinical significance, Dr. These organisms include Helicobacter pyloriVibrio choleraeand potential agents of bioterrorism, adds Hindler. The Experts James H. His e-mail address is glenmcdan aol. These methods may also be used to evaluate commercial devices for routine use. Prompt, accurate identification of a bacterial pathogen is one of the most valuable services the microbiology laboratory provides for clinicians in its efforts to positively impact patient care.


Results generated by these reference methods may in fact be used by regulatory agencies to evaluate the performance of commercial systems as part of their approval systems.

Before the publication of this guideline, a review of the literature revealed very few systematic studies on testing these organisms, Dr. Commercial susceptibility testing devices are not specifically addressed by M In such cases, in vitro antimicrobial susceptibility of the organism isolated is most likely indicated.

While comprehensive, the guideline is not prescriptive, and allows some degree of customization of criteria and policies by each laboratory and its medical staff. According to James H. A Case Report and Literature Review. Its encompassing nature establishes M45 as an invaluable resource to various constituencies, including the clinical laboratory. Established guidelines exist for susceptibility testing of some organisms. Jorgensen identifies these developments as the most obvious benefits of M Sign In or Create an Account.

Interested facilities should contact CLSI for more information, including purchasing options, on this essential document. Citing articles via Google Scholar.