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Defining epidemiological cutoff values for Brucella melitensis: an European multicentre study.

Flavia Dematheis1, Joseph Papaparaskevas2, Erika Matuschek3

  • 1Bundeswehr Institute of Microbiology, Central Diagnostic Department, Munich, Germany.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|September 13, 2025
PubMed
Summary
This summary is machine-generated.

Standardized antimicrobial susceptibility testing (AST) methods for Brucella melitensis were validated. Epidemiological cutoff values (ECOFFs) were established, aiding in the detection of potential resistance mechanisms to key antibiotics.

Keywords:
Brucella melitensisantimicrobial susceptibility testingclinical breakpointsepidemiological cutoff valuewild-type MIC distributions

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Brucellosis, primarily caused by Brucella melitensis, poses a significant risk for chronic infections and relapses.
  • Standardized antimicrobial susceptibility testing (AST) procedures and clinical breakpoints are crucial for effective patient management and treatment outcomes.
  • A Europe-wide network of Brucella reference laboratories collaborated with EUCAST to address the need for standardized AST.

Purpose of the Study:

  • To establish standardized AST methods for Brucella melitensis.
  • To determine wild-type (WT) minimum inhibitory concentrations (MICs) and zone diameter distributions.
  • To set epidemiological cutoff (ECOFF) values for nine therapeutically relevant antimicrobial agents.

Main Methods:

  • A total of 499 B. melitensis strains were tested across six European study centers.
  • Broth microdilution (BMD) and disc diffusion (DD) methods were employed for AST.
  • MICs and inhibition zone diameters were curated according to EUCAST standard operating procedure (SOP) 10.2 for ECOFF determination.

Main Results:

  • Putative wild-type distributions were observed for tested antimicrobial agents using BMD and DD.
  • MIC ECOFFs were determined for all agents, with six isolates showing slightly elevated MICs suggesting potential resistance mechanisms to rifampicin, streptomycin, and trimethoprim-sulfamethoxazole.
  • ECOFFs were established for rifampicin and ceftriaxone, with tentative ECOFFs for ciprofloxacin, levofloxone, gentamicin, and streptomycin.

Conclusions:

  • Standardized BMD and DD methodologies for B. melitensis were validated.
  • EUCAST utilized the AST results to set ECOFFs, which were incorporated into the EUCAST clinical breakpoints table (v14.0).
  • These advancements enable sensitive detection and monitoring of antimicrobial resistance development in B. melitensis.