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Related Concept Videos

Microbial Growth Measurement: Direct Methods01:23

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Direct methods for measuring microbial populations in a culture are essential tools in microbiology, providing quantitative data for various applications. Among these, microscopic counts, plate counts, and serial dilution are widely used techniques, each with unique principles and applications.Microscopic CountsMicroscopic counting involves the use of a Petroff-Hausser chamber, a specialized microscope slide with a grid and defined depth. By observing a liquid culture under a microscope,...
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Updated: May 7, 2026

A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
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Validation of EUCAST zone diameter breakpoints against reference broth microdilution.

S Bengtsson1, C Bjelkenbrant, G Kahlmeter

  • 1Department of Clinical Microbiology, Central Hospital, Växjö, Sweden.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|October 15, 2013
PubMed
Summary
This summary is machine-generated.

The European Committee on Antimicrobial Susceptibility Testing (EUCAST) disc diffusion method shows high agreement with the International Standard Organization (ISO) broth microdilution reference. This validation supports EUCAST breakpoints for accurate antimicrobial susceptibility testing.

Keywords:
Antimicrobial susceptibility testingEUCAST clinical breakpointsEUCAST disc diffusion methodbroth microdilutiondisc diffusion

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Area of Science:

  • Clinical Microbiology
  • Antimicrobial Resistance
  • Diagnostic Testing

Background:

  • The European Committee on Antimicrobial Susceptibility Testing (EUCAST) has harmonized clinical breakpoints in Europe since 2002.
  • Development of a disc diffusion method by EUCAST began in 2009, with breakpoints calibrated to MIC values published in December 2009.

Purpose of the Study:

  • To validate EUCAST clinical zone diameter breakpoints against the International Standard Organization (ISO) reference broth microdilution method.
  • To assess the accuracy and reliability of the EUCAST disc diffusion method for antimicrobial susceptibility testing.

Main Methods:

  • A total of 544 bacterial isolates (238 Gram-negative, 306 Gram-positive) were tested.
  • Antimicrobial susceptibility testing was performed using both ISO-compliant broth microdilution and EUCAST disc diffusion methodologies.
  • Inhibition zone diameters and Minimum Inhibitory Concentration (MIC) values were interpreted using EUCAST clinical breakpoint table version 2.0.

Main Results:

  • Overall categorical agreement (CA) between disc diffusion and broth microdilution was high at 97.3% across 5231 organism-agent combinations.
  • Low rates of discrepancies were observed: 2.1% minor (mD), 0.5% major (MD), and 0.1% very major (VMD).
  • Higher CA was noted for Gram-positive (98.7%) compared to Gram-negative isolates (96.2%). Seven VMDs occurred, primarily in Staphylococcus species and Pseudomonas aeruginosa.

Conclusions:

  • The EUCAST disc diffusion method demonstrates excellent correlation with the ISO reference broth microdilution method.
  • EUCAST clinical zone diameter breakpoints are reliable for differentiating susceptible, intermediate, and resistant bacterial isolates.
  • The validated disc diffusion method supports accurate and standardized antimicrobial susceptibility testing across Europe.