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Reference Services SACU 2023

Reference core services (Accredited to ISO 15189):

  • Confirmatory susceptibility testing on a number of antimicrobials
  • Susceptibility testing of antimicrobial agents for difficult to treat infections 
  • Confirmation of resistance mechanism in “Resistance Alert” isolates
  • Confirmation of unusual resistances EUCAST advice on intrinsic resistence and unusual phenotypes (EUCAST 2023) 
  • Confirmation of specific resistance/resistance mechanism using genotypic and/or phenotypic methods. These include (but not exclusive to):
    • Confirmation of carbapenem resistance plus carbapenemase detection (VIM, IMP, NDM, KPC and OXA-48-like genes) in all Gram-negative bacteria (Please see exclusions document)
    • Confirmation of oxacillinase (OXA-23-like, OXA-24-like and OXA-58-like) in  Acinetobacter species
    • Extended Spectrum Beta-Lactamase (ESBL) in Gram-negative bacteria
    • Vancomycin (Glycopeptide) resistance in Enterococcus species (VRE)
    • Colistin MIC by microbroth dilution**
    • Mobile Colistin Resistance (mcr-1 to mcr-10) in gram negative bacteria 
    • High-level mupirocin resistance in S. aureus
    • Methicillin resistance in S. aureus
  • Panton-Valentine Leucocidin (PVL) detection [Please note that PVL testing will only be performed when sufficient clinical details of risk factors are provided] 

** Due to recent service developments, laboratory accreditation for these tests is currently awaiting UKAS confirmation.

Additional services following discussion (Not accredited to ISO 15189):

  • Agar dilution, broth microdilution for MIC confirmation where appropriate
  • Broth microdilution MIC testing: Pseudomonas aeruginosa isolated from cystic fibrosis patients
  • Outbreak support - this may include antibiogram, resistance mechanism and typing analysis plus advice on likely routes of dissemination. Contact SACU for discussion/advice
  • Combination (Synergy) testing of antimicrobials using broth microdilution, gradient strips or time kill curves will be offered with appropriate discussion 
  • Determination of GISA (Homogeneous glycopeptide intermediate S. aureus) and hGISA (Heterogeneous glycopeptide intermediate S. aureus)

Advisory and Scientific:

  • Advice on alternative antimicrobial therapy & management of resistant infections
  • Support for local EUCAST susceptibility testing methodology & guidelines
  • Advice on performance and interpretation of susceptibility testing
  • Advice on quality control for susceptibility testing
  • Support for local and national projects 
  • Advice on screening for antimicrobial resistant organisms 

Specific information on any service offered