title: Tracking the implementation of NCCLS M100-S12 expanded-spectrum cephalosporin MIC breakpoints for nonmeningeal isolates of Streptococcus pneumoniae by clinical laboratories in the United States during 2002 and 2003.
abstract: BACKGROUND
  The Performance Standards for Antimicrobial Susceptibility Testing, Twelfth Informational Supplement, M100-S12, published by the National Committee for Clinical Laboratory Standards (NCCLS) in January 2002 introduced distinct minimum inhibitory concentration (MIC) interpretative breakpoints for ceftriaxone, cefotaxime, and cefepime for nonmeningeal isolates of Streptococcus pneumoniae. Previously, a single set of interpretative breakpoints was used for both meningeal and nonmeningeal isolates.
  
  
  METHODS
  To estimate the rate of adoption of the M100-S12 interpretive breakpoints by clinical laboratories, antimicrobial susceptibility test results for ceftriaxone and cefotaxime from nonmeningeal S. pneumoniae isolates were studied using data collected from January 2002 to June 2003 by The Surveillance Network Database--USA (TSN, an electronic surveillance database.
  
  
  RESULTS
  Of the 262 laboratories that provided data that could be evaluated, 67.6% had adopted the M100-S12 breakpoints one and one-half years after they were published.
  
  
  CONCLUSIONS
  The NCCLS M100-S12 recommendation to interpret MICs to expanded-spectrum cephalosporins using two distinct sets of breakpoints for meningeal and nonmeningeal isolates of S. pneumoniae was steadily implemented by clinical microbiology laboratories in the United States following their initial publication in January 2002. The use of these new breakpoints more accurately reflects the clinical activities of expanded-spectrum cephalosporins than did the single set of interpretative breakpoints previously used for both meningeal and nonmeningeal isolates.
authors.affiliation: Focus Technologies, 13665 Dulles Technology Drive, Suite 200, Herndon, VA 20171-4603, USA. rmaster@focustechnologies.com
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Master
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Draghi
authors.forename: Mark E
authors.initials: ME
authors.lastname: Jones
authors.forename: Clyde
authors.initials: C
authors.lastname: Thornsberry
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Sahm
authors.forename: James A
authors.initials: JA
authors.lastname: Karlowsky