title: [Antimicrobial resistance, ESBL and MRSA--definitions and laboratory diagnostics].
abstract: In the light of frequent discussions about the correct performance of in vitro susceptibility testing and the interpretation of the results obtained, the aim of the present report is to summarize basic facts that may facilitate the understanding of this complex topic. For this, the terms "antimicrobial resistance", "ESBL", and "MRSA" are defined. Besides the statements on antimicrobial resistance, information on intrinsic and acquired resistance properties as well as basic rules for the correct performance of antimicrobial susceptibility testing in routine diagnostics are presented. Moreover, the two groups of interpretive criteria--clinical breakpoints and epidemiological cut-off values--including their applications are explained in detail. Furthermore, currently valid diagnostic procedures--as published by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Clinical and Laboratory Standards Institute (CLSI)--for the screening of ESBL-producing Enterobacteriaceae and MRSA as well as for the confirmation of suspicious isolates are presented and compared. Based on the information given, it becomes obvious that the correct performance of the diagnostic tests, which includes strict following the performance standards and the detailed information given therein, is an indispensable prerequisite for a standardized and harmonized in vitro susceptibility testing and--as a consequence--for the determination of valid and reliable susceptibility data in routine diagnostics. This is of utmost importance since the susceptibility data based on the use of clinical breakpoints often represent the basis for therapeutic interventions.
authors: Geovana Brenner
authors: GB
authors: Michael
authors: Christin
authors: C
authors: Freitag
authors: Andrea T
authors: AT
authors: Fessler
authors: Sarah
authors: S
authors: Wendlandt
authors: Christopher
authors: C
authors: Eidam
authors: Monika
authors: M
authors: Entorf
authors: Graciela Volz
authors: GV
authors: Lopes
authors: Anne
authors: A
authors: Riesenberg
authors: Stefanie
authors: S
authors: Blodkamp
authors: Stefan
authors: S
authors: Schwarz
authors: Kristina
authors: K
authors: Kadlec
mesh_terms: D000818:Animals; D001424:Bacterial Infections / Q000382:microbiology / Q000662:veterinary; D001431:Bacteriological Techniques / Q000379:methods; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008826:Microbial Sensitivity Tests; D009626:Terminology as Topic; D014730:Veterinary Medicine / Q000379:methods*; D001618:beta-Lactamases
chemical_list: D001618:beta-Lactamases