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CLSI document MA2. Wayne, PA: Clinical and Laboratory Standards Institute; Proposed Guideline. October Approved Guideline. May 15 Aug CLSI M Methods for Antimicrobial Dilution and Disk Susceptibility Testing of Infrequently Isolated or Fastidious Bacteria; Third Edition. Fastidious Organisms: CLSI MA2 update. Diane M. Citron. SWACM, R.M. Alden Research Lab. Culver City, CA. History. ▫ CLSI has provided testing.

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His e-mail address is glenmcdan aol. Prompt, accurate identification of a bacterial pathogen is one of the most valuable clsu the microbiology laboratory provides for clinicians in its efforts to positively impact patient care. Established guidelines exist for susceptibility testing of some organisms.

Jorgensen identifies these developments as the most obvious benefits of M Jorgensen and Hindler both agree that this revised guideline is very timely, in light of the increasingly common challenges faced by laboratories performing susceptibility testing on these organisms, including increased pressure from clinicians to provide susceptibility data quickly, and the need for reliable methods to identify emerging resistance.

CLSI is a global, nonprofit organization that promotes the development and use of voluntary consensus standards and guidelines within the health care community. Interested facilities should contact CLSI for more information, including purchasing options, on this essential document. Receive exclusive offers and updates from Oxford Academic.

This guideline is based somewhat on standardized procedures in other documents, but contains specific instructions on when and how to perform antimicrobial susceptibility testing of fastidious or infrequently isolated organisms that might be resistant to therapy commonly prescribed through antibiotics. A Case Report and Literature Review.


According to James H. Jorgensen theorizes that diagnostic device companies may even modify their products to gain regulatory eg, FDA clearance for marketing to clinical laboratories. While comprehensive, the guideline is not prescriptive, and allows some ,45 of customization of criteria and policies by each laboratory and its medical staff. However, clinicians need prompt guidance on treating organisms that can cause serious, life-threatening infections eg, bacteremia, endocarditis, and meningitis.

For some of the organisms, a disk diffusion method is described, and this method can be easily adopted by most clinical laboratories performing disk diffusion testing. The methods described are generic reference methods that can be used cls routine susceptibility testing by most clinical laboratories.

Oxford University Press is a department of the University of Oxford. However, there are instances in which the sensitivity of such a pathogen cannot be predicted simply based on the identity of clei organism.

Commercial susceptibility testing devices are not specifically addressed by M M45 does not suggest that laboratories test all infrequently encountered or fastidious isolates, especially if they are of dubious clinical significance, Dr. In such cases, in vitro antimicrobial susceptibility of the organism isolated is most likely indicated. Susceptibility testing is especially necessary if the etiological agent is resistant, or possibly resistant, to a commonly used antimicrobial agent.

These methods may also be used to evaluate commercial devices for clxi use. Citing articles via Google Scholar. Before the publication of this guideline, a review of the literature revealed very few clsu studies on testing these organisms, Dr. Jorgensen, PhD, chairholder of the CLSI working group that developed the csi, it has long been accepted that for the most effective management of bacterial infections, laboratories must be able to determine susceptibility or resistance to therapeutic agents.


Related articles in Google Scholar.

It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. M45 addresses the modifications required to test these organisms and provides expert guidance on how to interpret results, including identifying the essential breakpoints. However, in cases clwi as those involving fastidious and infrequently isolated organisms for which specific guidelines do not exist, laboratorians have resorted to various alternative methods and applied breakpoints from other groups of organisms.

Results generated by these reference methods may in fact be used by regulatory agencies to evaluate the performance of commercial systems as part of their approval xlsi. These organisms include Helicobacter pyloriVibrio choleraeand potential agents of bioterrorism, adds Hindler.

Jorgenson stresses the importance of understanding their distinction from M Jorgensen offers an example of how this guideline might be used in a typical laboratory. The Experts James H. Working group member Paul C. Therefore, laboratories need specific guidelines on how c,si perform valid susceptibility testing without using the US Food and Drug Administration FDA -cleared instrumentation and commercial m5 systems found in most laboratories.

Sign In or Create an Account. Email alerts New issue alert. Close mobile search navigation Article navigation. Its encompassing nature establishes M45 as an invaluable resource to various constituencies, including the clinical laboratory.