ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2020
Breakpoint beware: reliance on historical breakpoints for Enterobacteriaceae leads to discrepancies in interpretation of susceptibility testing for carbapenems and cephalosporins and gaps in detection of carbapenem-resistant organisms.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Proposed Meropenem Breakpoints for Interpretation of Antimicrobial Susceptibility Testing of Bacteria Isolated From Dogs.Journal of veterinary pharmacology and therapeutics · 2026Article
- Article
- From detection to decision: how laboratory testing and reporting strategies can shape management of carbapenemase-producingASM case reports · 2025Article
- Cefepime failure for the treatment of cefepime-susceptible, KPC-producingASM case reports · 2025Article
- Comparison of BD Phoenix and disk diffusion to broth microdilution for determining cefepime susceptibility among carbapenem-resistant Enterobacterales.Journal of clinical microbiology · 2024Article
- Development of Modernized Acinetobacter baumannii Susceptibility Test Interpretive Criteria for Recommended Antimicrobial Agents Using Pharmacometric Approaches.Antimicrobial agents and chemotherapy · 2023Article
- Raising the Bar: Improving Antimicrobial Resistance Detection by Clinical Laboratories by Ensuring Use of Current Breakpoints.Open forum infectious diseases · 2022Article
- The Practical Problem With Carbapenem Testing and Reporting Accurate Bacterial Susceptibilities.Frontiers in pharmacology · 2022Review
- The Collateral Effects of COVID-19 Pandemic on the Status of Carbapenemase-Producing Pathogens.Frontiers in cellular and infection microbiology · 2022Review
- The antibiogram: key considerations for its development and utilization.JAC-antimicrobial resistance · 2021Review
- Reporting Considerations for Cefepime-Susceptible and -Susceptible-Dose Dependent Results for Carbapenemase-ProducingJournal of clinical microbiology · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
Carbapenem-resistant Enterobacteriaceae (CRE) are an important public health and infection prevention threat. CRE are typically detected via phenotypic antimicrobial susceptibility testing (AST), for which interpretive standards were modified in recent years. Our objective was to measure the impact of breakpoint changes on AST interpretation for CRE. Zone sizes from disk diffusion AST for Enterobacteriaceae isolates recovered from clinical cultures over a 1-year period (n = 10,183) and CRE from clinical and environmental sources from the USA and Pakistan (n = 342) were evaluated. Results were interpreted according to historical (CLSI M100-S19) and current (CLSI M100-S29) breakpoints. Interpretive errors were calculated according to the FDA definitions. Using current breakpoints as the reference standard, 56 (17%) very major (false susceptibility) errors occurred for cefepime and 13 (45%) very major errors for meropenem interpretation using historical breakpoints in clinical isolates of Enterobacteriaceae, corresponding to 12 carbapenemase-producing CRE that would have been missed during the 1-year period. For confirmed bla
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