Antimicrobial Susceptibility Test Discs · Antimicrobial Susceptibility Test Discs As per CLSI...
Transcript of Antimicrobial Susceptibility Test Discs · Antimicrobial Susceptibility Test Discs As per CLSI...
Antimicrobial Susceptibility Test DiscsAs per CLSI (Clinical Laboratory Standards Institute) Guidelines (Formerly NCCLS)
Susceptibility Test Procedure
Precaution
Note
1. Prepare plates with Mueller Hinton Agar (AM1071/AM5071) for use in the Bauer-Kirby Method for rapidly growing aerobic organisms. For fastidious organisms such as Streptococci, the agar (AM1071/AM5071) is supplemented with 5% sterile, defibrinated blood. For spp. Haemophilus Test Medium and for , GC Agar Base (AM1046/AM5046) with 1% defined growth supplement are recommended respectively. The medium in the plates should be sterile and have a depth of about 4 mm.
2. Use pure cultures as inoculum. Select 3-4 similar colonies and transfer them into about 5 ml of suitable broth such as Tryptone Soya Broth (AM1092/AM5092). Incubate at 35-37 C for 2-8 hours till light to moderate turbidity develops. Adjust the turbidity to yield a uniform suspension containing 10 – 10 cells/ml [i.e. 0.5 MCFarland standard (Cat. No.: 20701040)]. If the turbidity in the broth is sufficient, further incubation is not necessary.
3. Dip a sterile non-toxic cotton swab on a wooden applicator into the standardized inoculum (turbidity so adjusted, as to obtain confluent growth on the petri plate) and rotate the soaked swab firmly against the upper inside wall of the tube to express excess fluid. Streak the entire agar surface of the plate with the swab three times, turning the plate at 60 angle between each streaking. Allow the inoculum to dry for 5 – 15 minutes with lid in place.
4. Apply the discs using aseptic technique. Deposit the discs with centers at least 24 mm apart. For fastidious organisms and for Penicillins and Cephalosporins, the discs should preferably be deposited with centers 30 mm apart.
5. Incubate immediately at 35-37 C and examine after 16-18 hours or later if necessary. Measure the zones showing complete inhibition and record the diameters of the zones to the nearest millimeter.
1. Accuracy of the test depends on the disc potency, proper inoculum, functional pretested medium plates (nature of medium and its depth), inoculation technique, incubation temperature and time etc.
2. To maintain the potency of discs, store the stock containers of discs in the freezer at -20 C. The discs when required for use within a week , may be kept in refrigerator (below 8 C) and the remainder should be kept with desiccant and tightly closed container caps in the freezer.
3. Remove the antimicrobial discs from refrigerator to room temperature 1-2 hours before use to avoid moisture condensation. Return unused discs to refrigerator immediately after applications.
4. Once a cartridge is opened it is recommended that it is stored for no more than one week.5. While reading results:
(a) Ignore swarming of species if zones of inhibition are clearly defined.(b) Measure the sulphonamide zones at the margin of heavy growth since Sulphonamide may not inhibit organisms for several
generations and slight growth may appear within zones of inhibition.(c) Subculture, reidentify and retest any large colony growing within a clear zone of inhibition.
6. Control tests using known cultures should be included each time a sensitivity test is performed.7. Antibacterial agents other than those listed in interpretative chart are in current use. Susceptibility tests employing these agents
should be interpreted on the basis of presence or absence of a definite zone of inhibition and should be considered as only qualitative until the time interpretative zones have been established.
1. Ampicillin disc is used for testing susceptibility to amoxycillin as well.2. Cephalothin disc is used for testing susceptibility to Cephapirin, Cephaloridine, Cephalexin, Cefaclor, Cephoxitin, Cefazolin,
Cephradine and Cephadroxil as well.3. The Sulfisoxazole (Suphafurazole) disc can be used to represent any of the currently available sulfonamide preparations.4. The category “Intermediate” should be reported. Infections with bacteria of intermediate susceptibility may be considered
moderately susceptible and may respond to antimicrobial agents with a wide safe dosage range.5. Since certain strains of spp. have been reported to give false susceptible results with Cefprozil discs, strains of this
genus should not be tested & reported with this disc.6. All isolates with zone diameters of 14 mm or less should be tested by an MIC (Minimal Inhibitory Concentration)
method.7. When testing Vancomycin against , plates should be held a full 24 hrs & examined using transmitted light; the presence
of a haze or any growth within the zone of inhibition indicates resistance.8. Ofloxacin susceptible will also be susceptible to Levofloxacin.9. Susceptibility & resistance to Azithromycin, Clarithromycin & Dirithromycin can be predicted by using Erythromycin for
.10. The expiry date of the product is mentioned only on carton and pouch.11. Biogram antimicrobial susceptibility test disc dispenser is provided inside the carton.
Haemophilus N. gonorrhoeae
Proteus
Providencia
staphylococcal
Enterococci
S. pneumoniae
Streptococci
0
5 6
0
0
0
0
TMBiogramTM
BIOGRAMTM
Zone Size Interpretative Chart(Based on results obtained using Mueller Hinton Agar)
Productcode
Antimicrobial Agent Symbol
Diameter of zone of inhibition in mm
Quality Control, Limits
Disc content
Resis-tant mmor less
Inter-mediate mm
Sensi-tive mmor more
E.coli S.aureus P.aeru-ginosa
E.coli H.influ-enzae
H.influ-enzae
S.pneu-moniae
N.gonorr-hoeae
ATCC25922
ATCC25923
ATCC27853
ATCC35218
ATCC49247
ATCC49766
ATCC49619
ATCC49226
AK 30 mcg 14 15-16 17 19-26 20-26 18-26 - - - - -AAMK00030010
AAMC00010005 AMCAAMC00010010 When testing spp.
and When testing
AMPA00010005 AMP 10 mcgAMPA00010010 When testing 13 14-16 17 16-22 - - 6 - - - -
When testing 28 - 29 - 27-35 - - - - - -When testing spp. 18 19-21 22 - - - - 13-21 - - -When testing - - - - - - - - - 30-36 -When testing 18 19-25 26 - - - - - - - -other than When testing spp. 16 - 17 - - - - - - - -
AASA00010005AASA00010010 When testing 11 12-14 15 19-24 29-37 - 13-19 - - - -
and When testing spp. 19 - 20 - - - - 14-22 - - -
AAZT00015005AAZT00015010 When testing spp. - - 12 - - - - 13-21 - - -
AAZR00030005 AT 30 mcgAAZR00030010 When testing and 15 16-21 22 28-36 - 23-29 - - - - -
When testing spp. - - 26 - - - - 30-38 - - -
ACRB00100005ACRB00100010 When testing 19 20-22 23 23-29 - - - - - - -
When testing 13 14-16 17 - - 18-24 - - - - -
ACFA00030005 CF 30 mcgACFA00030010 When testing - - - - - - - - -
ACZN00030005 CZ 30 mcg 14 15-17 18 21-27 29-35 - - - - - -ACZN00030010
ACFD00005005 CDRACFD00005010 When testing 16 17-19 20 24-28 25-32 - - - 24-31 - -
and When testing - - - - - - - - - - 40-49When testing - - - - - - - - - 26-31 -
ACFP00030005 CPM 30 mcgACFP00030010 When testing 14 15-17 18 31-37 23-29 24-30 - - - - -
and When testing spp. - - 26 - - - - 25-31 - - -When testing - - 31 - - - - - - - 37-46When testing other 21 22-23 24 - - - - - - - - than When testing - - - - - - - - - 28-35 -
ACFI00005005ACFI00005010 When testing 15 16-18 19 23-27 - - - - - - -
When testing spp. - - 21 - - - - 25-33 - - -When testing - - 31 - - - - - - - 37-45When testing - - - - - - - - - 16-23 -
ACEF00075005 CPZ 75 mcg 15 16-20 21 28-34 24-33 23-29 - - - - -ACEF00075010
ACFT00030005 CTX 30 mcgACFT00030010 When testing spp.
When testing When testing 25 26-27 28 - - - - - - - -other than When testing - - 31 - - - - - - - 38-48
ACPD00010005 ACPD00010010 When testing 17 18-20 21 23-28 19-25 - - - - - -
and When testing spp. - - 21 - - - - 25-31 - - -When testing - - 29 - - - - - - - 35-43When testing - - - - - - - - - 28-34 -
Amikacin
Amoxycillin / C lavulanic acid
Ampicillin
Ampicillin / Sulbactam
Azithromycin
Aztreonam
Carbenicillin
Cefaclor
Cefazolin
Cefdinir
Cefepime
Cefixime
Cefoperazone
Cefotaxime (Cephotaxime)
Cefpodoxime
AAMK00030005
AMKV00030005
20/10mcg 19 - 20 - 28-36 - 17-22 15-23 - - -
AMCV00010005 (30mcg)13 14-17 18 18-24 - - - - - - -
AMPV00010005
A/S 10/10 mcg
AASV00010005
AZM 15 mcg 13 14-17 18 - 21-26 - - - - 19-25 -
AZTV00015005
AZRV00030005
CB 100 mcg
ACBV00100005
14 15-17 18 23-27 27-31 - - - 25-31 - -24-32 -
ACAV00030005
ACNV00030005
5 mcg
ACDV00005005
ACPV00030005
CFM 5 mcg
ACFV00005005
ACEV00075005
14 15-22 23 29-35 25-31 18-22 - - - - -- - 26 - - - - 31-39 - - -
ACTV00030005 - - - - - - - - - 31-39 -
CPD 10 mcg
APDV00010005
Haemophilus Staphylococci
Enterobacteriaceae
EnterobacteriaceaeStaphylococciHaemophilus S.pneumoniaeStreptococcus
S. pneumoniaeEnterococcus
Enterobacteriaceae Staphylococci
Haemophilus
Haemophilus
EnterobacteriaceaeP. aeruginosa
Haemophilus
P. aeruginosa
Streptococci
StaphylococciN. gonorrhoeaeS. pneum oniae
Enterobacteriaceae,P. aeruginosa Staphylococci
HaemophilusN. gonorrhoeaeStreptococcus
S. pneumoniaeS. pneum oniae
HaemophilusN. gonorrhoeaeS. pneum oniae
HaemophilusS. pneum oniaeStreptococcus
S. pneumoniaeN. gonorrhoeae
Enterobacteriaceae Staphylococci
HaemophilusN. gonorrhoeaeS. pneum oniae
Enterobacteriaceae
Enterobacteriaceae
Enterobacteriaceae
Zone Size Interpretative Chart(Based on results obtained using Mueller Hinton Agar)
Productcode
Antimicrobial Agent Symbol
Diameter of zone of inhibition in mm
Quality Control, Limits
Disc content
Resis-tant mmor less
Inter-mediate mm
Sensi-tive mmor more
E.coli S.aureus P.aeru-ginosa
E.coli H.influ-enzae
H.influ-enzae
S.pneu-moniae
N.gonorr-hoeae
ATCC25922
ATCC25923
ATCC27853
ATCC35218
ATCC49247
ATCC49766
ATCC49619
ATCC49226
ACFR00030005ACFR00030010 When testing 14 15-17 18 21-27 27-33 - - - 20-27 - -
and When testing - - - - - - - - - 25-32 -
ACFZ00030005ACFZ00030010 When testing spp. - - 26 - - - - 27-35 - - -
When testing - - 31 - - - - - - - 35-43
ACFX00030005ACFX00030010 When testing - - 38 - - - - - - - 42-51
When testing spp. - - 26 - - - - 29-39 - - -
ACTR00030005ACTR00030010 When testing spp. - - 26 - - - - 31-39 - -
When testing - - - - - - - - - 30-35 -When testing 24 25-26 27 - - - - - - - -other than When testing - - 35 - - - - - - - 39-51
ACFU00030005 CXM 30 mcg 14 15-17 18 20-26 27-35 - - - - - -ACFU00030010 When testing 25 26-30 31 - - - - - - - 33-41
When testing spp. 16 17-19 20 - - - - - 28-36 - -
ACPH00030005 CEP 30 mcg 14 15-17 18 15-21 29-37 - - - - 26-32 -ACPH00030010
ACHL00030005ACHL00030010 When testing spp. 25 26-28 29 - - - - 31-40 - - -
When testing 20 - 21 - - - - - - 23-27 -When testing 17 18-20 21 - - - - - - - -other than
ACIP00005005ACIP00005010 When testing spp. - - 21 - - - - 34-42 - - -
When testing 27 28-40 41 - - - - - - - 48-58
ACLR00015005ACLR00015010 When testing 16 17-20 21 - - - - - - 25-31 -
When testing 13 14-17 18 - 26-32 - - - - - -When testing spp. 10 11-12 13 - - - - 11-17 - - -
ACLI00002005ACLI00002010 When testing 14 15-20 21 - 24-30 - - - - - -
When testing 15 16-18 19 - - - - - - 19-25 -
ACOL00010005 CL 10 mcg 10 - 11 11-17 - 11-17 - - - - -ACOL00010010 (Methane Sulphonate)
ACOT00125005 (Trimethoprim /ACOT00125010 Sulphamethoxazole)
When testing 15 16-18 19 - - - - - - 20-28 -
ADEX00030005 DO 30 mcg 12 13-15 16 18-24 23-29 - - - - - -ADEX00030010
AETP00010005AETP00010010 When testing 15 16-18 19 29-36 24-31 - - - - - -
and spp.When testing spp. - - 19 - - - - 20-28 27-33 - -
AERY00015005AERY00015010 When testing 13 14-22 23 - 22-30 - - - - - -
spp.When testing 15 16-20 21 - - - - - - 25-30 -
AFUR00005005 FAR 5 mcg - - - 20-26 27-34 - - 15-22 - 27-35 -AFUR00005010
AGTI00005005AGTI00005010 When testing , 14 15-17 18 30-37 - 20-28 - - - - -
spp.When testing , 19 20-22 23 - 27-33 - - - - - -When testing spp. - - 18 - - - - 33-41 - - -When testing 17 18-20 21 - - - - - - 24-31 -When testing 33 34-37 38 - - - - - - - 45-56
AGEM00005005AGEM00005010 When testing 15 16-19 20 29-36 27-33 19-25 - - - 28-34 -
and When testing spp. - - 18 - - - - 30-37 - - -
Cefprozil
Ceftazidime
Ceftizoxime
Ceftriaxone
Cefuroxime
Cephalothin
Chloramphenicol
Ciprofloxacin
Clarithromycin
Clindamycin
Colistin
Co-Trimoxazole
Doxycycline Hydrochloride
Ertapenem
Erythromycin
Faropenem
Gatifloxacin
Gemifloxacin
CFR 30 mcg
AFRV00030005
CAZ 30 mcg 14 15-17 18 25-32 16-20 22-29 - - - - -
AFZV00030005
CZX 30 mcg 14 15-19 20 30-36 27-35 12-17 - - - 28-34 -
AFYV00030005
CTR 30 mcg 13 14-20 21 29-35 22-28 17-23 - - - - -
ACRV00030005
ACUV00030005
ACHV00030005
C 30 mcg 12 13-17 18 21-27 19-26 - - - - - -
ACLV00030005
CIP 5 mcg 15 16-20 21 30-40 22-30 25-33 - - - - -
AIRV00005005
CLR 15 mcg
ALRV00015005
CD 2 mcg
ALIV00002005
ACOV00010005
COT 1.25/ 10 11-15 16 23-29 24-32 - - 24-32 - - -23.75 mcg
AOTV00125005
ADEV00030005
ETP 10 mcg - - - - - 13-21 - - - 28-35 -
AETV00010005
E 15 mcg
AERV00015005
AFUV00005005
GAT 5 mcg
AGTV00005005
GEM 5 mcg
AGEV00005005
EnterobacteriaceaeStaphylococci
S. pneum oniae
Haemophilus N. gonorrhoeae
N. gonorrhoeaeHaemophilus
HaemophilusS. pneum oniaeStreptococcus
S. pneumoniaeN. gonorrhoeae
N. gonorrhoeaeHaemophilus
HaemophilusS. pneum oniae Streptococcus
S. pneumoniae
HaemophilusN. gonorrhoeae
StreptococciStaphylococciHaemophilus
StaphylococciStreptococci
S. pneum oniae
Enterobacteriaceae Staphylococcus
Haemophilus
Staphylococci,Entercoccus
Streptococci
EnterobacteriaceaeEnterococcus
StaphylococciHaemophilusStreptococciN. gonorrhoeae
Enterobacteriaceae Staphylococci,
Haemophilus
Zone Size Interpretative Chart(Based on results obtained using Mueller Hinton Agar)
Productcode
Antimicrobial Agent Symbol
Diameter of zone of inhibition in mm
Quality Control, Limits
Disc content
Resis-tant mmor less
Inter-mediate mm
Sensi-tive mmor more
E.coli S.aureus P.aeru-ginosa
E.coli H.influ-enzae
H.influ-enzae
S.pneu-moniae
N.gonorr-hoeae
ATCC25922
ATCC25923
ATCC27853
ATCC35218
ATCC49247
ATCC49766
ATCC49619
ATCC49226
AGNT00010005 GEN 10 mcg 12 13-14 15 19-26 19-27 16-21 - - - - -AGNT00010010
AIPM00010005AIPM00010010 When testing spp. - - 16 - - - - 21-29 - - -
AKAN00030005 K 30 mcg 13 14-17 18 17-25 19-26 - - - - - -AKAN00030010
ALEV00005005ALEV00005010 When testing , 15 16-18 19 - - - - - - - -
When testing , 13 14-16 17 29-37 25-30 19-26 - - - - - spp and .
When testing spp. - - 17 - - - - 32-40 - 20-25 -
ALIZ00030005ALIZ00030010 When testing & - - 21 - - - - - - - -
.When testing spp. 20 21-22 23 - - - - - - - -
ALOM00010005ALOM00010010 When testing 26 27-37 38 - - - - - - - 45-54
When testing spp. - - 22 - - - - 33-41 - - -
AMRP00010005AMRP00010010 When testing , 13 14-15 16 28-34 29-37 27-33 - - - - -
and When testing spp. - - 20 - - - - 20-28 - - -When testing - - - - - - - - - 28-35 -
AMIN00030005 MI 30 mcg 14 15-18 19 19-25 25-30 - - - - - -AMIN00030010
AMOX00005005AMOX00005010 When testing 20 21-23 24 - - - - - - - -
When testing spp. - - 18 - - - - - - - -When testing . 14 15-17 18 - - - - - - - -
ANLI00030005 NA 30 mcg 13 14-18 19 22-28 - - - - - - -ANLI00030010
ANTL00030005 (Netilm icin Sulphate) NET 30 mcg 12 13-14 15 22-30 22-31 17-23 - - - - -ANTL00030010
ANTR00300005 NIT 300 mcg 14 15-16 17 20-25 18-22 - - - - 23-29 -ANTR00300010
ANRF00010005ANRF00010010 When testing - - - - - - - - - 15-21 -
AOFL00005005AOFL00005010 When testing spp. - - 16 - - - - 31-40 - - -
When testing . 12 13-15 16 - - - - - - 16-21 -When testing 24 25-30 31 - - - - - - - 43-51When testing 14 15-17 18 - - - - - - - -
AOXN00001005AOXN00001010 When testing 10 11-12 13 - 18-24 - - - - - -
When testing coagulase 17 - 18 - - - - - - - -negative When testing - - - - - - - - - 12
APNC00010005 - APNC00010010 When testing 28 - 29 - 26-37 - - - - - -
When testing - - 20 - - - - - - 24-30 -When testing 19 20-27 28 - - - - - - - -other than When testing 26 27-46 47 - - - - - - - 26-34When testing 16 - 17 - - - - - - - -
APPR00100005APPR00100010 When testing
When testing 17 18-20 21 24-30 - - - - - - -
Gentamicin
Imipenem
Kanamycin
Levofloxacin
Linezolid
Lomefloxacin
Meropenem
Minocycline
Moxifloxacin
Nalid ixic Acid
Netillin
Nitrofurantoin
Norfloxacin
Ofloxacin
Oxacillin
Penicill in G
Piperacillin
AGNV00010005
AHLG00120005 HLG 120 mcg - - - - - - - - - - -AHLG00120010AHGV00120005
IPM 10 mcg 13 14-15 16 26-32 - 20-28 - - - - -
APMV00010005
AKAV00030005
LE 5 mcg
ALVV00005005
LZ 30 mcg - - - - 25-32 - - - - 25-34 -
ALZV00030005
LOM 10 mcg 18 19-21 22 27-33 23-29 22-28 - - - - -
ALOV00010005
MRP 10 mcg
AMRV00010005
AMIV00030005
MO 5mcg - - - 28-35 28-35 17-25 - 31-39 - 25-31 -
AMOV00005005
ANLV00030005
ANTV00030005
ANRV00300005
NX 10 mcg 12 13-16 17 28-35 17-28 22-29 - - - - -
ANFV00010005
OF 5 mcg 12 13-15 16 29-33 24-28 17-21 - - - - -
AOFV00005005
OX 1 mcg
AOXV00001005
-
P 10 units
APNV00010005
PI 100 mcg17 - 18 - - 25-33 12-18 - - - -
APPV00100005
Gentamicin
Haemophilus
StaphylococciEnterobacteriaceae
Enterococcus StreptococciHaemophilus
Staphylococci Streptococci
Enterococcus
N. gonorrhoeaeHaemophilus
EnterobacteriaceaeStaphylococci P.aeruginosa
HaemophilusS. pneum oniae
StaphylococciHaemophilusStreptococci
S. pneum oniae
HaemophilusStreptococciN. gonorrhoeaeStaphylococci
Staphylococci
StaphylococciS. pneum oniae
StaphylococciS. pneum oniae Streptococcus
S. pneumoniaeN. gonorrhoeaeEnterococcus
P. aeruginosaEnterobacteriaceae
< 0
Zone Size Interpretative Chart(Based on results obtained using Mueller Hinton Agar)
Productcode
Antimicrobial Agent Symbol
Diameter of zone of inhibition in mm
Quality Control, Limits
Disc content
Resis-tant mmor less
Inter-mediate mm
Sensi-tive mmor more
E.coli S.aureus P.aeru-ginosa
E.coli H.influ-enzae
H.influ-enzae
S.pneu-moniae
N.gonorr-hoeae
ATCC25922
ATCC25923
ATCC27853
ATCC35218
ATCC49247
ATCC49766
ATCC49619
ATCC49226
APIT00100005APIT00100010 When testing 17 18-20 21 24-30 - - 24-30 - - - -
When testing &17 - 18 - 27-36 25-33 - - - - -
When testing spp. - - - - - - - 33-38 - - -
APOL00300005 PB 300 units 11 - 12 13-19 - 14-18 - - - - -APOL00300010
ARFM00005005ARFM00005010 When testing - - - 8-10 - - - - - - -
When testing spp., 16 17-19 20 - 26-34 - - 22-30 - - - and spp.
When testing 16 17-18 19 - - - - - - 25-30 -
ASPR00005005ASPR00005010 When testing - - - 30-38 - - - - - - -
When testing - - - - - - - - - - 43-51When testing spp. - - - - - - - 32-40 - - -
ASPT00100005 SPT 100 mcg 14 15-17 18 - - - - - - - 23-29ASPT00100010
ASTR00010005 S 10 mcg 11 12-14 15 12-20 - - - - - - -ASTR00010010 - - - - 14-22 - - - - - -
ATEI00030005 TEI 30 mcg 10 11-13 14 - 15-21 - - - - - -ATEI00030010
ATTR00030005ATTR00030010 When testing spp. 25 26-28 29 - - - - 14-22 - - -
When testing spp. 18 19-22 23 - - - - - - 27-31 -When testing 30 31-37 38 - - - - - - - -30-42
ATIC00075005ATIC00075010 When testing 14 - 15 - - 21-27 6 - - - -
When testing 14 15-19 20 24-30 - - - - - - -
ATCC00075005ATCC00075010 When testing 14 15-19 20 24-30 - - 21-25 - - - -
When testing 14 - 15 - - 20-28 - - - - -When testing 22 - 23 - 29-37 - - - - - -
ATBR00010005 TOB 10 mcg 12 13-14 15 18-26 19-29 19-25 - - - - -ATBR00010010
ATRM00005005 TR 5 mcg 10 11-15 16 21-28 19-26 - - - - - -ATRM00005010
AVNC00030005AVNC00030010 When testing spp. - - 15 - 17-21 - - - - - -
When testing spp. - - 17 - - - - - - 20-27 -When testing spp. 14 15-16 17 - - - - - - - -
Piperacillin/ Tazobactam
Polymyxin-B
Rifampicin
Sparfloxacin
Spectinomycin
Streptomycin
Teicoplanin
Tetracycline
Ticarcillin
Ticarcillin /
Tobramycin
Trimethoprim
Vancomycin
PIT 100/10 mcg
APIV00100005
APOV00300005
AULI00005005 PRU 5 mcg - - - 32-38 20-26 27-33 - - - - -AULI00005010AULV00005005
RIF 5 mcg
ARFV00005005
SPX 5 mcg 15 16-18 19 - 27-33 21-29 - - - 21-27 -
ASPV00005005
ASYV00100005
When testing ASRV00010005
AHLS00300005 HLS 300 mcg - - - - - - - - - - -AHLS00300010 When testing AHSV00300005
ATEV00030005
TE 30 mcg 14 15-18 19 18-25 19-28 - - - - - -
ATTV00030005
TI 75 mcg
ATIV00075005
TCC 75/10 mcg
ATCV00075005
ATBV00010005
ATRV00005005
VA 30 mcg
AVNV00030005
EnterobacteriaceaeStaphylococci
Haemophilus
E. coli,Enterococcus
Staphylococci HaemophilusS. pneumoniae
E. coliN. gonorrhoeaeHaemophilus
HaemophilusStreptococci N. gonorrhoeae
P. aeruginosaEnterobacteriaceae
EnterobacteriaceaeP. aeruginosaStaphylococci
Staphylococci StreptococciEnterococcus
P. aeruginosa
Staphylococci
Staphylococci
Prulifloxacin (Ulifloxacin)
Streptomycin
Clavulanic acid
Note: 1. For control limits of Gentamycin 120 mcg (AHLG00120005/AHLG00120010) use ATCC 29212, standard 16-23 mm (HLG).2. For control limits of streptomycin 300 mcg (AHLS00300005/AHLS00300010) use ATCC 29212, standard 14-20 mm (HLS).
∆ : For : Muller Hinton Agar.For Haemophilus spp: Haemophilus Test Medium; For : Muller Hinton Agar with 5% sheep blood;For : GC Agar Base with 1% defined growth supplement.
: Deterioration in Oxacillin disc content is bestassessed with QC organism ATCC 25923, with an acceptable zone diameter of 18-24 mm.
E. faecalisE. faecalis
E. coli, S. aureus, P.aeruginosa S. pneumoniaeN. Gonorrhoeae
S. aureus
q
Antifungal Susceptibility Test Procedure
Preparation of Inoculum
Susceptibility Test Procedure
Precautions:
Zone Size Interpretative Chart for Antifungal Agent(Based on results obtained on Mueller Hinton Agar + 2% Glucose + 0.5 mcg/ml Methylene Blue Dye Medium)
µ
,
1. Inoculum is prepared by picking five distinct colonies of approximately 1mm from 24 hours old culture grown on SabouraudDextrose Agar (AM1087/AM5087) incubated at 35-37 C. Colonies are suspended in 5 ml of sterile 0.85% Saline.
2. Vortex the resulting suspension and adjust the turbidity to yield 1 x 10 - 5 x 10 cells/ml [i.e. 0.5 MCFarland standard (Cat. No.: 20701040)].
1. Prepare plates with Mueller Hinton Agar (AM1071/AM5071) +2% Glucose and 0.5 g/ml Methylene Blue Dye (GMB) Medium forcarrying out susceptibility of antifungal discs. The medium in the plates should be sterile and have a depth of about 4 mm.
2. Dip a sterile non-toxic cotton swab on a wooden applicator into the standardized inoculum (turbidity so adjusted, as to obtain semiconfluent growth on the petri plate) and rotate the soaked swab firmly against the upper inside wall of the tube to express excessfluid, Streak the entire agar surface of the plate with the swab three times, turning the plate at 60 angle between each streaking.Allow the inoculum to dry for 5-15 minutes with lid in place.
3. Apply the discs using aspectic technique. Deposit the discs with centers at least 24 mm apart.4. Invert the plates and place in an incubator set to within 15 minutes after the discs are applied.5. Examine each plate after 20-24 hours of incubation. If plate was satisfactorily streaked the resulting zones of inhibition will be
uniformly circular and there will be a semi-confluent lawn of growth. Read at 48 hours only when insufficient growth is observedafter 24 hours incubation.
1. Accuracy of the test depends on the disc potency, proper inoculum, functional pretested medium plates (nature of medium and itsdepth), inoculation technique incubation temperature and time, etc.
2. To maintain the potency of discs, store the stock containers of discs in the freezer at -20 C. The discs when required for use withina week, may be kept in refrigerator (below 8 C) and the remainder should be kept with tightly closed container caps in the freezer.
3. Remove the antimicrobial discs from refrigerator to room temperature 1-2 hours before use to avoid moisture condensation.Return unused discs to refrigerator immediately after applications.
4. Measure the zone diameter to the nearest whole millimeter at the point at which there is prominent reduction in growth. Pinpointmicro colonies at the zone edge or large colonies within a zone are encountered frequently & should be ignored.
0
6 6
0
0
0
* :
. .
35-37 C0
Zone diameter, Nearest whole (mm) Quality Control Limits
AFLC00025005 Fluconazole FLC 25 mcg 14 15-18 19 28-39 22-33 26-37 - 25-30 -AFLC00025010
AVRC00001005 Voriconazloe VRC 1 mcg 13 14-16 17 31-42 28-37 - 16-25 30-40 29-38AVRC00001010
Product Antimicrobial agent Symbol Disc Resistant S- DD* SensitiveCode
C.albicans C.parapsilosis C.tropicalis C. krusei C.albicans S.cerevisiae content mm or less mm or more ATCC 90028 ATCC 22019 ATCC 750 ATCC 6258 ATCC 10231 ATCC 9763
AFLV00025005
AVRV00001005
S - DD - Susceptible - Dose Dependent
1. 2. Method for Antifungal Disk Diffusion Susceptibility Testing of Yeasts; Approved Guidelines Vol 24 No. 15, May 2004 NCCLS document M44-A. For more details refer to this volume
Reference:Bauer, Kirby, Sherris and Turck, 1966, Am. J. Clin. Path., 45:493.
3. Performance Standards for Antimicrobial Disk susceptibility Tests, CLSI Vol. 29 No. 3, Jan. 2009. For more details refer to this volume.
Quality Control Limits for Antibiotics not as per CLSI(Based on results obtained using Mueller Hinton Agar)
Antibiotics concentration of these products are as per customer requirements. These codes do not have concentration of antibiotics as per CLSI (Formerly NCCLS) standards.
Diameter of zone of inhibition in mm
Quality Control Limits*
Product Antimicrobial Symbol D isc ATCC ATCC ATCC Code Agent Content 25922 25923 27853
E.coli S.aureus P.aeruginosa
ACIT00030005 Ceftriaxone/ CIT 30/10 mcg 29-35 24-32 17-24ACIT00030010 TazobactamAITV00030005
ACIT00080005 Ceftriaxone/ CIT 80/10 mcg 29-35 24-32 17-24ACIT00080010 TazobactamAITV00080005
ACHL00010005 Chloramphenicol C 10 mcg 17-25 19-26 -ACHL00010010ACLV00010005
ACHL00050005 Chloramphenicol C 50 mcg 23-29 25-32 -ACHL00050010ACLV00050005
ACHL00025005 Chloramphenicol C 25 mcg 21-27 23-30 -ACHL00025010ACLV00025005
ACIP00010005 Ciprofloxacin CIP 10 mcg 30-40 27-35 28-35ACIP00010010AIRV00010005
ACIP00030005 Ciprofloxacin CIP 30 mcg 30-40 27-35 28-35ACIP00030010AIRV00030005
AIRV00001005
ALIV00010005
AOOV00001005
AOOV00005005
AOOV00010005
AOOV00030005
ACOV00025005
ACOV00050005
ADEV00010005
AERV00010005
AERV00005005
AUEV00050005
AGNV00050005
AGNV00030005
AGTV00010005
AGTV00030005
AICV00010005
AKAV00005005
ALNV00002005
ALNV00010005
ALNV00015005
ALOV00030005
ALOV00015005
ANYV00030005
ANTV00010005
ACIP00001005 Ciprofloxacin CIP 1 mcg 26-36 20-28 22-30ACIP00001010
ACLI00010005 Clindamycin CD 10 mcg - 28-34 -ACLI00010010
ACOX00001005 Cloxacillin COX 1 mcg - 18-24 -ACOX00001010
ACOX00005005 Cloxacillin COX 5 mcg - 18-30 -ACOX00005010
ACOX00010005 Cloxacillin COX 10 mcg - 23-34 -ACOX00010010
ACOX00030005 Cloxacillin COX 30 mcg - 30-40 -ACOX00030010
ACOL00025005 Colis tin CL 25 mcg 11-15 - 11-15ACOL00025010 (Methane Sulphonate)
ACOL00050005 Colis tin CL 50 mcg 11-15 - 11-15ACOL00050010 (Methane Sulphonate)
ADEX00010005 Doxycycline DO 10 mcg 12-18 23-29 -ADEX00010010 Hydrochloride
AERY00010005 Erythromycin E 10 mcg - 22-30 -AERY00010010
AERY00005005 Erythromycin E 5mcg - 22-30 -AERY00005010
AFUR00050005 Furazolidone FR 50 mcg 20-25 18-22 -AFUR00050010
AGNT00050005 Gentamicin GEN 50 mcg 21-28 25-33 20-25AGNT00050010
AGNT00030005 Gentamicin GEN 30 mcg 21-28 24-32 19-24AGNT00030010
AGTI00010005 Gatif loxacin GAT 10 mcg 30-37 27-33 20-28AGTI00010010
AGTI00030005 Gatif loxacin GAT 30 mcg 32-40 31-37 24-32AGTI00030010
AICN00010005 Imipenam/ IC 10/10 mcg 28-35 - 24-31AICN00010010 Cilastin
AKAN00005005 Kanamycin K 5 mcg 16-22 19-26 -AKAN00005010
ALIN00002005 Lincomycin L 2 mcg - 15-22 -ALIN00002010
ALIN00010005 Lincomycin L 10mcg - 15-22 -ALIN00010010
ALIN00015005 Lincomycin L 15 mcg - 22-32 -ALIN00015010
ALOM00030005 Lomefloxacin LOM 30 mcg 27-33 23-29 22-28ALOM00030010
ALOM00015005 Lomefloxacin LOM 15 mcg 28-36 24-32 22-30ALOM00015010
ANOM00030005 Neom ycin N 30 mcg 17-23 18-26 -ANOM00030010
ANTL00010005 Netillin NET 10 mcg 17-25 20-29 13-19ANTL00010010 (Netilmicin Sulphate)
Diameter of zone of inhibition in mm
Quality Control Limits*
Product Antimicrobial Symbol D iscCode Agent Content
E.coli S.aureus P.aeruginosa
AAM K00010005 Am ikacin AK 10 mcg 16-23 18-24 15-23AAM K00010010
AAM X00010005 Am oxycillin AMX 10 mcg 19-25 28-36 -AAM X00010010
AAM X00025005 Am oxycillin AMX 25 mcg 19-25 28-36 -AAM X00025010
AAM X00030005 Am oxycillin AMX 30 mcg 19-25 28-36 -AAM X00030010
AAM C00050005 Am oxyclav AMC 50/10 mcg 24-30 30-38 -AAM C00050010 (Amoxycillin/
AAM S00030005 Am oxycillin/ AMS 30/15 mcg 28-38 32-43 -AAM S00030010 Sulbactam
AAM L00010005 Am oxyclav AMC 10 mcg 19-25 28-36 -AAM L00010010
AMPA00002005 Am pic illin AMP 2 mcg 14-21 27-35 -AMPA00002010
AMPA00025005 Am pic illin AMP 25 mcg 20-30 32-40 -AMPA00025010
AAAX00010005 Am pic illin/ AX 10 mcg 16-22 35-37 -AAAX00010010 Cloxacillin
AAZT00030005 Azithromycin AZM 30 mcg - 24-30 -AAZT00030010
AAZR00050005 Aztreonam AT 50 mcg 29-37 - 24-33AAZR00050010
AABC00010005 Bacitrac in B 10 units - 12-22 -AABC00010010
AABC00080005 Bacitrac in B 8 units - 12-22 -AABC00080010
ACFD00030005 Cefadroxil CPR 30 mcg 12-18 26-32 -ACFD00030010 (Cephadroxil)
ACFN00030005 Cefalex in CN 30 mcg 17-22 29-37 -ACFN00030010 (Cephalex in)
ACFP00050005 Cefepim e CPM 50 mcg 32-40 26-34 27-35ACFP00050010
ACTB00080005 Cefepim e/ CPT 80/10 mcg 31-39 30-35 27-34ACTB00080010 Tazobactam
ACTB00030005 Cefepim e/ CPT 30/10 mcg 33-39 24-30 26-32ACTB00030010 Tazobactam
ACCA00050005 Cefixime/ CMC 5/10 m cg 24-32 - -ACCA00050010 Clavulanic ac id
ACFS00030005 Cefoperazone/ CFS 75/30 mcg 27-33 23-30 22-28ACFS00030010 Sulbactum
ACFS00010005 Cefoperazone/ CFS 75/10 mcg 27-33 23-30 20-25ACFS00010010 Sulbactum
ACFS00050005 Cefoperazone/ CFS 50/50 mcg 28-36 24-33 22-29ACFS00050010 Sulbactum
ACST00075005 Cefoperazone/ CST 75/10 mcg 27-32 23-30 22-28ACST00075010 Tazobactam
ACFT00010005 Cefotaxime CTX 10 mcg 29-35 25-31 18-22ACFT00010010 (Cephotaxime)
ACPM00030005 Cefpirome CFP 30 mcg 28-34 29-37 23-29ACPM00030010
ACCL00010005 Cefpodoxime/ CCL 10/5 m cg 17-23 13-19 -ACCL00010010 Clavulanic ac id
ACZC00030005 Ceftazidime/ CAC 30/10 mcg 27-34 18-22 -ACZC00030010 Clavulanic ac id
ACAT00080005 Ceftazidime/ CAT 80/10 mcg 25-32 19-28 23-30ACAT00080010 Tazobactam
ACAT00030005 Ceftazidime/ CAT 30/10 mcg 25-32 17-24 22-29ACAT00030010 Tazobactam
ACTR00010005 Ceftriaxone CTR 10 mcg 29-35 22-28 17-23ACTR00010010
ACIS00030005 Ceftriaxone/ CIS 30/15 mcg 31-37 24-30 16-21ACIS00030010 Sulbactam
ATCC ATCC ATCC 25922 25923 27853
AMKV00010005
AAM V00010005
AAM V00025005
AAM V00030005
Clavulanic ac id)AMCV00050005
AMSV00030005
AMLV00010005
AMPV00002005
AMPV00025005
AAXV00010005
AZTV00030005
AZRV00050005
ABCV00010005
ABCV00080005
AFDV00030005
ANNV00030005
ACPV00050005
ABBV00080005
ABBV00030005
ACCV00050005
ACSV00030005
ACSV00010005
ACSV00050005
ACVV00075005
ACTV00010005
AMMV00030005
ALLV00010005
AZZV00030005
AAAV00080005
AAAV00030005
ACRV00010005
AIIV00030005
Quality Control Limits
ATCC 90028 ATCC 22019 ATCC 750 ATCC 6258 ATCC 10231 ATCC 9763Product Code Antimicrobial Agent Symbol Disc Content C.parapsilosis C.tropicalis C. krusei C.albicans S.cerevisiaeC.albicans
AAPB00100005 /
AAPB00020005 /
AAPB00050005 /
ACCE00010005 /
AFLC00010005 /
AITE00010005 /
AITE00030005 /
AKTE00010005 /
AKTE00030005 /
AKTE00050005 /
ANSN00100005 /
ANSN00050005 /
AAPB00100010 / AAPV00100005 Amphotericin-B AP 100 units 10-17 11-20 08-12 09-14 10-18 11-18
AAPB00020010 / AAPV00020005 Amphotericin-B AP 20 mcg 10-15 10-17 08-10 08-12 10-16 08-12
AAPB00050010 / AAPV00050005 Amphotericin-B AP 50 mcg 12-15 13-17 13-17 14-20 15-23 16-25
ACCE00010010 / ATCV00010005 Clotrimazole CC 10 mcg 18-32 16-30 10-20 14-24 12-18 17-25
AFLC00010010 / AFLV00010005 Fluconazole FLC 10 mcg 27-38 22-33 16-25 - 18-22 -
AITE00010010 / AIOV00010005 Itraconazole IT 10 mcg 16-20 11-18 08-13 08-15 18-22 -
AITE00030010 / AIOV00030005 Itraconazole IT 30 mcg 18-22 20-24 11-18 08-15 18-22 -
AKTE00010010 / AKTV00010005 Ketoconazole KT 10 mcg 20-32 14-29 17-28 10-14 18-22 -
AKTE00030010 / AKTV00030005 Ketoconazole KT 30 mcg 32-36 26-32 26-32 19-26 31-40 -
AKTE00050010 / AKTV00050005 Ketoconazole KT 50 mcg 37-45 36-44 27-34 19-26 31-40 -
ANSN00100010 / ANSV00100005 Nystatin NS 100 units 19-27 16-25 16-21 15-20 15-23 17-25
ANSN00050010 / ANSV00050005 Nystatin NS 50 mcg 19-23 19-23 13-17 19-26 16-25 22-27
Diameter of zone of inhibition in mm
Quality Control Limits*
Product Antimicrobial Symbol D isc ATCC ATCC ATCC Code Agent Content 25922 25923 27853
Code Agent
E.coli S.aureus P.aeruginosa
ASRN00030005 Spiramycin SR 30 mcg - 22-29 -ASRN00030010ASNV00030005
ASRN000100005 Spiramycin SR 100 mcg - 22-29 -ASRN000100010ASNV000100005
ASTR00025005 Streptomycin S 25 mcg 15-23 17-25 -ASTR00025010ASRV00025005
ATTV00010005
ATBV00030005
ATRV00010005
ATRV00025005
ATRV00030005
ATLV00015005
AVNV00005005
AVNV00010005
AMTT00005010 / ATMV00005005
AMTT00004010 / ATMV00004005
ATTR00010005 Tetracyc line TE 10 mcg 18-25 24-30 -ATTR00010010
ATBR00030005 Tobramycin TOB 30 mcg 18-26 19-29 19-25ATBR00030010
ATRM 00010005 Trim ethoprim TR 10 mcg 21-28 19-26 -ATRM 00010010
ATRM 00025005 Trim ethoprim TR 25 mcg 21-28 19-26 -ATRM 00025010
ATRM 00030005 Trim ethoprim TR 30 mcg 21-28 19-26 -ATRM 00030010
ATLS00015005 Tylos ine TL 15 mcg - 22-30 -ATLS00015010
AVNC00005005 Vancom ycin VA 5 mcg - 15-19 -AVNC00005010
AVNC00010005 Vancom ycin VA 10 mcg - 17-21 -AVNC00010010
* : Expected diameter of zone of inhibit ion.
AMTT00005005 / Metronidazole MT 5 mcg
AMTT00004005 / Metronidazole MT 4mcg
Culture Response: Susceptibility test of Metronidazole discs (AMTT00005005 & AMTT00004005) is carried out by incorporating it into 5 ml Fluid Thioglycollate M edium (AM1045/AM5045). It is incubated at 35-37 C for 24 hours and results are recorded on the basis of appearance of growth us ing (ATCC 12924) as a test organism.
0 luxuriant1 good3 poor to good5 poor7 none* addition to 5 ml medium
Product Antimicrobial Symbol Disc Content
No. of Discs* Growth
0
Cl.perfringens
Diameter of zone of inhibition in mm
Quality Control Limits*
Product Antimicrobial Symbol D isc ATCC ATCC ATCC Code Agent Content 25922 25923 27853
E.coli S.aureus P.aeruginosa
ANTR00100005 Nitrofurantoin NIT 100 mcg 20-25 18-22 -ANTR00100010ANRV00100005
ANTR00200005 Nitrofurantoin NIT 200 mcg 20-25 18-22 -ANTR00200010ANRV00200005
ANVV00030005
ANVV00005005
AOFV00002005
AOXV00005005
AOYV00030005
APFV00005005
APNV00002005
APOV00050005
APOV00100005
AULV00001005
ARFV00002005
ARFV00030005
ARFV00015005
AROV00030005
ANOV00030005 Novobiocin NV 30 mcg - 22-31 -ANOV00030010
ANOV00005005 Novobiocin NV 5 mcg - 22-31 -ANOV00005010
AOFL00002005 Ofloxac in OF 2 mcg 29-33 24-28 17-21AOFL00002010
AOXN00005005 Oxacillin OX 5 mcg - 27-35 -AOXN00005010
AOXY00030005 Oxytetracycline O 30 mcg 18-25 19-28 -AOXY00030010
APFC00005005 Pefloxac in PF 5 mcg 29-33 24-28 17-21APFC00005010
APNC00002005 Penicillin-G P 2 units - 26-37 -APNC00002010
APOL00050005 Polym yxin B PB 50 units 12-16 - 11-17APOL00050010
APOL00100005 Polym yxin B PB 100 units 12-16 - 11-17APOL00100010
AULI00001005 Prulifloxacin PRU 10 mcg 28-34 19-27 24-32AULI00001010 (Ulifloxacin)
ARFM00002005 Rifampicin RIF 2 mcg 8-10 26-34 -ARFM00002010
ARFM00030005 Rifampicin RIF 30mcg 9-12 32-40 -ARFM00030010
ARFM00015005 Rifampicin RIF 15mcg 8-10 26-34 -ARFM00015010
AROY00030005 Roxithromycin RO 30 mcg - 22-30 -AROY00030010
Quality Control Limit for Antifungal Agent not as per CLSI(Based on result obtained on Mueller Hinton Agar + 2% Glucose + 0.5 mcg/ml Methylene Blue Dye Medium)
Qarad b.v.b.a. Cipalstraat 3, B-2440 Geel, BelgiumEC REP
LOT
Use byLot Number
ROReceived on
-20 C0
8 C0
Store at -20-8 C0 Manufacturer
REFCatalogue Number
Consult Instructions for use
IVDIn vitro Diagnostic
Medical DeviceHygroscopic keep
container tightly closed
OOOpened on
H EC REPAuthorised
Representative