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Objective  We studied whether the change in antibiotic susceptibility testing (AST) guidelines from CLSI to EUCAST influenced cumulative antibiograms in a tertiary care hospital in Switzerland.    Methods  Antibiotic susceptibilities of non-duplicate isolates collected within a one-year period before (period A) and after (period B) changing AST interpretation from CLSI 2009 to EUCAST 1.3 (2011) guidelines were analysed. In addition, period B isolates were reinterpreted according to the CLSI 2009, CLSI 2013 and EUCAST 3.1 (2013) guidelines.    Results  The majority of species/drug combinations showed no differences in susceptibility rates comparing periods A and B. However, in some gram-negative bacilli, decreased susceptibility rates were observed when comparing CLSI 2009 with EUCAST 1.3 within period B:  Escherichia coli  / cefepime, 95.8% (CLSI 2009) vs. 93.1% (EUCAST 1.3), P=0.005;  Enterobacter cloacae  / cefepime, 97.0 (CLSI 2009) vs. 90.5% (EUCAST 1.3), P=0.012;  Pseudomonas aeruginosa  / meropenem, 88.1% (CLSI 2009) vs. 78.3% (EUCAST 1.3),  P =0.002. These differences were still evident when comparing susceptibility rates according to the CLSI 2013 guideline with EUCAST 3.1 guideline. For  P. aeruginosa  and imipenem, a trend towards a lower antibiotic susceptibility rate in ICUs compared to general wards turned into a significant difference after the change to EUCAST: 87.9% vs. 79.8%,  P =0.08 (CLSI 2009) and 86.3% vs. 76.8%,  P =0.048 (EUCAST 1.3).    Conclusions  The change of AST guidelines from CLSI to EUCAST led to a clinically relevant decrease of susceptibility rates in cumulative antibiograms for defined species/drug combinations, particularly in those with considerable differences in clinical susceptibility breakpoints between the two guidelines.

Change of Antibiotic Susceptibility Testing Guidelines from CLSI to EUCAST: Influence on Cumulative Hospital Antibiograms