Table Of ContentProduct Name: Infobase 2010 - Release Date: February 2010
M100-S20
Vol. 30 No. 1
Replaces M100-S19
January 2010 Vol. 29 No. 3
Performance Standards for Antimicrobial
Susceptibility Testing; Twentieth
Informational Supplement
This document provides updated tables for the Clinical and Laboratory Standards
Institute antimicrobial susceptibility testing standards M02-A10 and M07-A8.
An informational supplement for global application developed through the Clinical and
Laboratory Standards Institute consensus process.
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Clinical and Laboratory Standards Institute
Advancing Quality in Health Care Testing
The Clinical and Laboratory Standards Institute (CLSI, Most documents are subject to two levels of consensus—
formerly NCCLS) is an international, interdisciplinary, “proposed” and “approved.” Depending on the need for
nonprofit, standards-developing, and educational field evaluation or data collection, documents may also be
organization that promotes the development and use of made available for review at an intermediate consensus
voluntary consensus standards and guidelines within the level.
health care community. It is recognized worldwide for
Proposed A consensus document undergoes the first stage
the application of its unique consensus process in the
of review by the health care community as a proposed
development of standards and guidelines for patient
standard or guideline. The document should receive a wide
testing and related health care issues. Our process is
and thorough technical review, including an overall review
based on the principle that consensus is an effective and
of its scope, approach, and utility, and a line-by-line review
cost-effective way to improve patient testing and health
of its technical and editorial content.
care services.
Approved An approved standard or guideline has achieved
In addition to developing and promoting the use of
consensus within the health care community. It should be
voluntary consensus standards and guidelines, we
reviewed to assess the utility of the final document, to
provide an open and unbiased forum to address critical
ensure attainment of consensus (ie, that comments on earlier
issues affecting the quality of patient testing and health
versions have been satisfactorily addressed), and to identify
care.
the need for additional consensus documents.
PUBLICATIONS
Our standards and guidelines represent a consensus opinion
A document is published as a standard, guideline, or on good practices and reflect the substantial agreement by
committee report. materially affected, competent, and interested parties
obtained by following CLSI’s established consensus
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procedures. Provisions in CLSI standards and guidelines
process that clearly identifies specific, essential
may be more or less stringent than applicable regulations.
requirements for materials, methods, or practices for use
Consequently, conformance to this voluntary consensus
in an unmodified form. A standard may, in addition,
document does not relieve the user of responsibility for
contain discretionary elements, which are clearly
compliance with applicable regulations.
identified.
COMMENTS
Guideline A document developed through the
consensus process describing criteria for a general The comments of users are essential to the consensus
operating practice, procedure, or material for voluntary process. Anyone may submit a comment, and all comments
use. A guideline may be used as written or modified by are addressed, according to the consensus process, by the
the user to fit specific needs. committee that wrote the document. All comments,
including those that result in a change to the document when
Report A document that has not been subjected to
published at the next consensus level and those that do not
consensus review and is released by the Board of
result in a change, are addressed by the committee in an
Directors.
appendix to the document. Readers are strongly encouraged
CONSENSUS PROCESS to comment in any form and at any time on any document.
Address comments to Clinical and Laboratory Standards
The CLSI voluntary consensus process is a protocol
Institute, 940 West Valley Road, Suite 1400, Wayne, PA
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Vol. 30 No. 1 M100-S20
Performance Standards for Antimicrobial Susceptibility Testing;
Twentieth Informational Supplement
Abstract
The supplemental information presented in this document is intended for use with the antimicrobial
susceptibility testing procedures published in the following Clinical and Laboratory Standards Institute
(CLSI)–approved standards: M02-A10—Performance Standards for Antimicrobial Disk Susceptibility
Tests; Approved Standard—Tenth Edition; and M07-A8—Methods for Dilution Antimicrobial
Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard—Eighth Edition. The
standards contain information about both disk (M02) and dilution (M07) test procedures for aerobic
bacteria.
Clinicians depend heavily on information from the clinical microbiology laboratory for treatment of their
seriously ill patients. The clinical importance of antimicrobial susceptibility test results requires that these
tests be performed under optimal conditions and that laboratories have the capability to provide results for
the newest antimicrobial agents.
The tabular information presented here represents the most current information for drug selection,
interpretation, and quality control using the procedures standardized in M02 and M07. Users should
replace the tables published earlier with these new tables. (Changes in the tables since the most current
edition appear in boldface type.)
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility
Testing; Twentieth Informational Supplement. CLSI document M100-S20 (ISBN 1-56238-716-2).
Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania
19087-1898 USA, 2010.
The data in the interpretive tables in this supplement are valid only if the
methodologies in M02-A10—Performance Standards for Antimicrobial Disk
Susceptibility Tests; Approved Standard—Tenth Edition; and M07-A8—Methods
for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow
Aerobically; Approved Standard—Eighth Edition are followed.
1
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2
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Product Name: Infobase 2010 - Release Date: February 2010
M100-S20
ISBN 1-56238-716-2
ISSN 0273-3099
Performance Standards for Antimicrobial Susceptibility Testing;
Twentieth Informational Supplement
Volume 30 Number 1
Franklin R. Cockerill, III, MD
Matthew A. Wikler, MD, MBA, FIDSA
Karen Bush, PhD
Michael N. Dudley, PharmD, FIDSA
George M. Eliopoulos, MD
Dwight J. Hardy, PhD
David W. Hecht, MD
Janet A. Hindler, MCLS, MT(ASCP)
Jean B. Patel, PhD, D(ABMM)
Mair Powell, MD, FRCP, FRCPath, MHRA
Richard B. Thomson, Jr., PhD
John D. Turnidge, MD
Melvin P. Weinstein, MD
Barbara L. Zimmer, PhD
Mary Jane Ferraro, PhD, MPH
Jana M. Swenson, MMSc
This document is protected by international copyright laws.
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January 2010 M100-S20
Copyright ©2010 Clinical and Laboratory Standards Institute. Except as stated below, neither this
publication nor any portion thereof may be adapted, copied, or otherwise reproduced, by any means
(electronic, mechanical, photocopying, recording, or otherwise) without prior written permission from
Clinical and Laboratory Standards Institute (“CLSI”).
CLSI hereby grants permission to each individual member or purchaser to make a single reproduction of
this publication for use in its laboratory procedure manual at a single site. To request permission to use
this publication in any other manner, contact the Executive Vice President, Clinical and Laboratory
Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898, USA.
Suggested Citation
CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Twentieth Informational
Supplement. CLSI document M100-S20. Wayne, PA: Clinical and Laboratory Standards Institute; 2010.
Twentieth Informational Supplement Fourteenth Informational Supplement
January 2010 January 2004
Nineteenth Informational Supplement Thirteenth Informational Supplement
January 2009 January 2003
Eighteenth Informational Supplement Twelfth Informational Supplement
January 2008 January 2002
Seventeenth Informational Supplement Eleventh Informational Supplement
January 2007 January 2001
Sixteenth Informational Supplement Tenth Informational Supplement
January 2006 January 2000
Fifteenth Informational Supplement Ninth Informational Supplement
January 2005 January 1999
ISBN 1-56238-716-2
ISSN 0273-3099
4
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Vol. 30 No. 1 M100-S20
p
Committee Membership hi
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Area Committee on Microbiology m
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JCohhanir Hho. lRdeexr , MD, FACP FCreepdh Cei.d T enover, PhD, ABMM JCaennat eMrs. fSowr eDnissoenas, eM CMonStcr ol and mitt
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AstraZeneca Sunnyvale, California, USA Prevention
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Cheshire, United Kingdom Young Harris, Georgia, USA C
John D. Turnidge, MD
Mary Jane Ferraro, PhD, MPH Women’s and Children’s Hospital Jeffrey L. Watts, PhD, RM(AAM)
Vice-Chairholder North Adelaide, Australia Pfizer Animal Health
Massachusetts General Hospital Kalamazoo, Michigan, USA
Boston, Massachusetts, USA Advisors
Melvin P. Weinstein, MD
Nancy L. Anderson, MMSc, Donald R. Callihan, PhD Robert Wood Johnson University
MT(ASCP) BD Diagnostic Systems Hospital
Centers for Disease Control and Sparks, Maryland, USA New Brunswick, New Jersey, USA
Prevention
Atlanta, Georgia, USA James H. Jorgensen, PhD Matthew A. Wikler, MD, MBA,
University of Texas Health Science FIDSA
Barbara Ann Body, PhD, D(ABMM) Center Institute for One World Health
Laboratory Corporation of America San Antonio, Texas, USA San Francisco, California, USA
Burlington, North Carolina, USA
Jean B. Patel, PhD, D(ABMM) Michael L. Wilson, MD
Betty (Betz) A. Forbes, PhD, Centers for Disease Control and Denver Health Medical Center
D(ABMM) Prevention Denver, Colorado, USA
Medical College of Virginia Campus Atlanta, Georgia, USA
Richmond, Virginia, USA Gail L. Woods, MD
Michael A. Pfaller, MD Central Arkansas Veterans Healthcare
Thomas R. Fritsche, MD, PhD University of Iowa College of System
Marshfield Clinic Medicine Little Rock, Arkansas, USA
Marshfield, Wisconsin, USA Iowa City, Iowa, USA
Barbara L. Zimmer, PhD
Freddie Mae Poole, BS, MT(ASCP, Thomas R. Shryock, PhD Siemens Healthcare Diagnostics
ISCLT) Elanco Animal Health West Sacramento, California, USA
FDA Center for Devices and Greenfield, Indiana, USA
Radiological Health
Upper Marlboro, Maryland, USA
Subcommittee on Antimicrobial Susceptibility Testing
Franklin R. Cockerill, III, MD George M. Eliopoulos, MD Mair Powell, MD, FRCP, FRCPath
Chairholder Beth Israel Deaconess Medical Center MHRA
Mayo College of Medicine Boston, Massachusetts, USA London, United Kingdom
Rochester, Minnesota, USA
Dwight J. Hardy, PhD Richard B. Thomson, Jr., PhD
Matthew A. Wikler, MD, MBA, University of Rochester Medical Center Evanston Hospital, Northwestern
FIDSA Rochester, New York, USA University Medical School
Vice-Chairholder Evanston, Illinois, USA
Institute for One World Health David W. Hecht, MD
San Diego, California, USA Loyola University Medical Center John D. Turnidge, MD
Maywood, Illinois, USA Women’s and Children’s Hospital
Karen Bush, PhD North Adelaide, Australia
Indiana University Janet A. Hindler, MCLS, MT(ASCP)
Bloomington, Indiana, USA UCLA Medical Center Melvin P. Weinstein, MD
Los Angeles, California, USA Robert Wood Johnson Medical School
Michael N. Dudley, PharmD, FIDSA New Brunswick, New Jersey, USA
Mpex Pharmaceuticals Jean B. Patel, PhD, D(ABMM)
San Diego, California, USA Centers for Disease Control and Barbara L. Zimmer, PhD
Prevention Siemens Healthcare Diagnostics
Atlanta, Georgia, USA West Sacramento, California, USA
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January 2010 M100-S20
hip Advisors Yoichi Hirakata, MD, FJSIM, PhD Sandra S. Richter, MD, D(ABMM)
s Tohoku University Graduate School of University of Iowa Carver College of
r
be Paul G. Ambrose, PharmD, FIDSA Medicine Medicine
m
ICPD/Orway Research Institute Sendai, Japan Iowa City, Iowa, USA
e
M Albany, New York, USA
e Ronald N. Jones, MD Flavia Rossi, MD
e
mitt Patricia A. Bradford, PhD JMI Laboratories University of Sao Paulo
Novartis Institutes for Biomedical North Liberty, Iowa, USA Sao Paulo, Brazil
m
o Research
C
Cambridge, Massachusetts, USA Gunnar Kahlmeter, MD, PhD Dale A. Schwab, PhD, D(ABMM)
ESCMID Quest Diagnostics, Nichols Institute
Steven D. Brown, PhD Växjö, Sweden San Juan Capistrano, California, USA
The Clinical Microbiology Institute
Wilsonville, Oregon, USA Frederic J. Marsik, PhD, ABMM Jana M. Swenson, MMSc
FDA Center for Drug Evaluation and Centers for Disease Control and
Karen Carroll, MD Research Prevention
Johns Hopkins Medical Institutions Silver Spring, Maryland, USA Atlanta, Georgia, USA
Baltimore, Maryland, USA
Linda A. Miller, PhD Fred C. Tenover, PhD, ABMM
Edward M. Cox, Jr., MD, MPH GlaxoSmithKline Cepheid
FDA Center for Drug Evaluation and Collegeville, Pennsylvania, USA Sunnyvale, California, USA
Research
Rockville, Maryland, USA Harriette L. Nadler, PhD Joseph G. Toerner, MD, MPH
DJA Global Pharmaceuticals, Inc. FDA Center for Disease Control and
William A. Craig, MD Chadds Ford, Pennsylvania, USA Prevention
Wm. S. Middleton Memorial Veterans Silver Spring, Maryland, USA
Affairs Hospital Freddie Mae Poole, BS, MT(ASCP,
Madison, Wisconsin, USA ISCLT) Hui Wang, PhD
FDA Center for Devices and Peking Union Medical College Hospital
Cynthia L. Fowler, MD Radiological Health Beijing, China
bioMérieux, Inc. Upper Marlboro, Maryland, USA
Durham, North Carolina, USA
Text and Table Working Group
Jana M. Swenson, MMSc Janet A. Hindler, MCLS, MT(ASCP) Susan D. Munro, MT(ASCP)
Chairholder UCLA Medical Center Stanford Hospital and Clinics
Centers for Disease Control and Los Angeles, California, USA Palo Alto, California, USA
Prevention
Atlanta, Georgia, USA Judy Johnston, MS Dale A. Schwab, PhD, D(ABMM)
Siemens Healthcare Diagnostics Quest Diagnostics, Nichols Institute
Donald R. Callihan, PhD West Sacramento, California, USA San Juan Capistrano, California, USA
BD Diagnostic Systems
Ronald N. Jones, MD
Sparks, Maryland, USA Albert T. Sheldon, Jr., PhD
JMI Laboratories
Antibiotic & Antiseptic Consultants
North Liberty, Iowa, USA
Franklin R. Cockerill, III, MD Cypress, Texas, USA
Mayo Clinic and Mayo College of
Dyan Luper, BS, MT(ASCP)SM
Medicine Richard B. Thomson, Jr., PhD
BD Diagnostic Systems
Rochester, Minnesota, USA Northwestern University Feinberg
Sparks, Maryland, USA
School of Medicine
Sharon K. Cullen, BS, RAC Linda M. Mann, PhD, D(ABMM) Evanston, Illinois, USA
Siemens Healthcare Diagnostics Siemens Healthcare Diagnostics
West Sacramento, California, USA West Sacramento, California, USA Mary K. York, PhD, ABMM
MKY Microbiology Consulting
Walnut Creek, California, USA
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Vol. 30 No. 1 M100-S20
Quality Control Working Group hip
rs
e
Steve Brown, PhD Michael D. Huband Paul E. Oefinger, PhD, D(ABMM) b
m
Co-Chairholder Pfizer Global R&D Covance Central Laboratory Services e
The Clinical Microbiology Institute Groton, Connecticut, USA Inc. e M
Wilsonville, Oregon, USA Indianapolis, Indiana, USA e
Ronald N. Jones, MD mitt
Sharon K. Cullen, BS, RAC JMI Laboratories Jean Patel, PhD, D(ABMM) m
Co-Chairholder North Liberty, Iowa, USA Centers for Disease Control and o
C
Siemens Healthcare Diagnostics Prevention
West Sacramento, California, USA Ann Macone Atlanta, Georgia, USA
Paratek Pharmaceuticals, Inc.
William Brasso Boston, Massachusetts, USA Robert P. Rennie, PhD
BD Diagnostic Systems University of Alberta Hospital
Sparks, Maryland, USA Ross Mulder, MT(ASCP) Edmonton, Alberta, Canada
bioMérieux, Inc.
Stephen Hawser, PhD Hazelwood, Missouri, USA
IHMA
Schaumburg, Illinois, USA Susan D. Munro, MT(ASCP)
Stanford Hospital and Clinics
Janet A. Hindler, MCLS, MT(ASCP) Palo Alto, California, USA
UCLA Medical Center
Los Angeles, California, USA
Staphylococcal Working Group
Fred Tenover, PhD, ABMM Michael N. Dudley, PharmD, FIDSA Maria M. Traczewski, BS, MT(ASCP)
Chairholder Mpex Pharmaceuticals The Clinical Microbiology Institute
Cepheid San Diego, California, USA Wilsonville, Oregon, USA
Sunnyvale, California, USA
George M. Eliopoulos, MD Melvin P. Weinstein, MD
Karen Bush, PhD Beth Israel Deaconess Medical Center Robert Wood Johnson University
Indiana University Boston, Massachusetts, USA Hospital
Bloomington, Indiana, USA New Brunswick, New Jersey, USA
Daniel F. Sahm, PhD
Patricia A. Bradford, PhD Eurofins Medinet
Novartis Institutes for Biomedical Herndon, Virginia, USA
Research
Cambridge, Massachusetts, USA Jana Swenson, MMSc
Centers for Disease Control and
William A. Craig, MD Prevention
University of Wisconsin Atlanta, Georgia, USA
Madison, Wisconsin, USA
Enterobacteriaceae Working Group
Michael N. Dudley, PharmD, FIDSA Ronald N. Jones, MD Jana Swenson, MMSc
Chairholder JMI Laboratories Centers for Disease Control and
Mpex Pharmaceuticals North Liberty, Iowa, USA Prevention
San Diego, California, USA Atlanta, Georgia, USA
Jean B. Patel, PhD, D(ABMM)
Centers for Disease Control and Lauri D. Thrupp, MD
Paul G. Ambrose, PharmD, FIDSA
Prevention University of California Irvine Medical
ICPD/Ordway Research
Atlanta, Georgia, USA Center
Albany, New York, USA
Orange, California, USA
David Paterson, MD
Karen Bush, PhD
Melvin P. Weinstein, MD
University of Pittsburgh
Indiana University
Robert Wood Johnson University
Pittsburgh, Pennsylvania, USA
Bloomington, Indiana, USA
Hospital
Paul C. Schreckenberger, PhD, New Brunswick, New Jersey, USA
William A. Craig, MD
D(ABMM), F(AAM)
University of Wisconsin Barbara L. Zimmer, PhD
Loyola University Medical Center
Madison, Wisconsin, USA Siemens Healthcare Diagnostics
Maywood, Illinois, USA
West Sacramento, California, USA
7
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hi Staff
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Wayne, Pennsylvania, USA
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mitt Lois M. Schmidt, DA
m Vice President, Standards Development
Co and Marketing
Tracy A. Dooley, BS, MLT(ASCP)
Staff Liaison
Melissa A. Lewis, ELS
Editorial Manager
Carol DiBerardino, MLA, ELS
Assistant Editor
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