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Updated: May 20, 2026

Application of the Intelligent High-Throughput Antimicrobial Sensitivity Testing/Phage Screening System and Lar Index of Antimicrobial Resistance

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Susceptibility testing methods, resistance and breakpoints: what do these terms really mean?

¹MB Consult Limited, Enterprise House, Ocean Village, Southampton S014 3XB, UK.

Revue Scientifique Et Technique (International Office of Epizootics)

|August 2, 2012

Summary

Harmonizing antimicrobial susceptibility testing definitions is crucial. Differences in terminology between major organizations like the Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing need urgent attention for accurate resistance interpretation.

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Published on: February 14, 2022

Area of Science:

Clinical Microbiology
Infectious Diseases
Pharmacology

Background:

Major international bodies like the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guide antimicrobial susceptibility testing (AST).
Discrepancies exist in the terminology and definitions used by these organizations for AST.
This variation can lead to confusion in interpreting resistance data.

Purpose of the Study:

To review and compare the approaches of CLSI and EUCAST in antimicrobial susceptibility testing.
To examine the terminology used in AST, particularly the definitions of resistance.
To advocate for the harmonization of AST definitions and breakpoints.

Main Methods:

Literature review of publications and guidelines from CLSI and EUCAST.
Analysis of terminology used in antimicrobial resistance definitions.
Discussion of susceptibility testing methodologies and breakpoint setting.

Main Results:

Significant differences in terminology, especially for defining antimicrobial resistance, were identified between CLSI and EUCAST.
A trend towards defining resistance by epidemiological cut-off values over clinical breakpoints was observed.
Current methodologies and approaches to setting clinical breakpoints were discussed.

Conclusions:

There is an urgent need to harmonize the definitions and terminology used in antimicrobial susceptibility testing globally.
Harmonization will improve the consistency and accuracy of resistance interpretation.
Standardized definitions are essential for effective antimicrobial stewardship and patient care.