IMPART

Kees Veldman, WBVR, Lelystad, NLProject coordinator

Lyngby, 26 April 2019

IMPART

IMproving Phenotypic Antimicrobial Resistance Testing

Joint Research Project

Period: 2 years (2018 – 2019)

https://onehealthejp.eu/projects/jrp1-impart/

https://onehealthejp.eu/projects/jrp1-impart/

IMPARTThirteen partners from nine countriesinvolving med, food and vet

DTU & SSI (DK), APHA & PHE (GB), ANSES (FR), PIWET (PL), SVA (SE), RIVM, WBVR & NCOH (NL), BfR (DE), NVI (NO), IZSLT (IT)

Total funding: €1.6 M€ (EU: €700 K€)

IMPARTThe project consists of 5 work packages:WP1: selective isolation and detection of colistin resistant Enterobacteriaceae (WPL: Sophie Granier, Anses)

WP2: selective isolation and detection of carbapenemase producing Enterobacteriaceae (WPL: Jannice Schau-Slettemeås, NVI)

WP3: establishing new ECOFFs (WPL: Kees Veldman, WBVR)

WP4: developing a disks diffusion method for AST of C. difficile (WPL: Sven Maurischat, BfR)

WP5: coordination and knowledge dissemination (WPL: Kees Veldman)

IMPART, WP3WP leader: Kees Veldman (WBVR)

Goal: setting ECOFFS for veterinary antimicrobials.

(1) improve harmonization of AMR monitoring in animal pathogens

(2) support defining clinical breakpoints of antimicrobials for veterinary use

WP3 participants

WP3 Leader: Kees Veldman (WBVR)Deputy WP3 Leader: Els Broens (NCOH)

9 participants:Anses (F), BfR (DE), APHA (GB), WBVR & NCOH (NL), NVI (N), PIWET (PL), SVA (SE), IZSLT (IT)

Background WP3: ECOFFs

• Epidemiological cut-off values (ECOFFs) are intended formonitoring purposes.

• EUCAST data base: https://mic.eucast.org/Eucast2/• Based on MIC distributions• Categories: wild-type (WT) and non wild-type (NWT)• To define clinical MIC breakpoints for veterinary

antimicrobial agents => ECOFFs required!

https://mic.eucast.org/Eucast2/

EUCAST SOP on MIC distribution and ECOFFs

Conditions for MIC distributions valid for aggregation:

• There must be a single peak in the putative wild-type MIC distribution. Distributions with a mode that spans two MIC values in the putative wild type can be aggregated.

• The range of antimicrobial concentrations tested should be sufficient to include the likely lowest and the likely highest MIC value for the putative wild-type distribution.

• There must be MIC values for at least 15 isolates in the putative wild-type distribution.

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IMPART, WP3

Establishing epidemiological cut-off values (ECOFFs)

Inventory, priority list and inclusion criteria

Month: 1 - 3

Producing MIC data

Month: 4 - 18

Collection and QC of MIC data

Month: 4 - 18

Publication of new ECOFFs

Month: 13 - 24

New planning (delivery of Sensititre plates was delayed)MIC testing + QC: April – November/December 2019Data analysis + setting ECOFFs: January – June 2020

Pert chart

WP5: coordination of the work packages and communicationWP1 and WP2: optimizing of isolation methods for detection of colistin-resistant and carbapenem-resistant Enterobacteriaceae

WP3: establishing epidemiological cut-off values (ECOFFs)

WP4: developing a standardized disk diffusion method for C. difficile

Describing and optimizing laboratory methods

Month:1 - 6

Inventory, priority list and inclusion criteria

Month: 1 - 3

Preparation of samples for final ring trial

Month:12 - 17

Performance of final ring trial

Month: 17

Producing MIC data

Month: 4 - 18

Analysis of the results and reporting

Month: 18 - 19

Publication of results in peer-reviewed journals

Month: 20 - 24

Collection and QC of MIC data

Month: 4 - 18

Publication of new ECOFFs

Month: 13 - 24

Establishing disk diffusion method

Month: 4 - 9

Performance of a ring trial study

Month: 9 - 12

Producing inhibition zone diameters

Month: 7 - 18

Pre-ring trials and evaluation

Month: 10 - 11

Preparation of samples for pre-ring trial

Month:7 - 8

Plan joint implementation

Month: 20 - 24

Assembly and characterization of strain collection

Month: 4 - 9

WP1 + WP2

Methods for detection of colistin-resistant and carbapenem-resistant Enterobacteriaceae

Describing and optimizing laboratory methods

Month:1 - 6

Preparation of samples for final ring trial

Month:12 - 17

Performance of final ring trial

Month: 17

Analysis of the results and reporting

Month: 18 - 19

Publication of new ECOFFs

Month: 13 - 24

Pre-ring trials and evaluation

Month: 10 - 11

Preparation of samples for pre-ring trial

Month:7 - 8

Plan joint implementation

Month: 20 - 24

WP3

Establishing epidemiological cut-off values (ECOFFs)

Inventory, priority list and inclusion criteria

Month: 1 - 3

Producing MIC data

Month: 4 - 18

Collection and QC of MIC data

Month: 4 - 18

Publication of new ECOFFs

Month: 13 - 24

WP-4

Developing a standardized disk diffusion method for C. difficile

Establishing disk diffusion method

Month: 4 - 9

Performance of a ring trial study

Month: 9 - 12

Producing inhibition zone diameters

Month: 7 - 18

Assembly and characterization of strain collection

Month: 4 - 9

IMPART – WP3

Deliverables: - Producing MIC distributions by testing bacterial

isolates from strain collections - Uploading the MIC distributions into the EUCAST

database- Set ECOFFs of veterinary pathogens for veterinary

antimicrobials

WP3, antimicrobial panels

Three different Sensititre panels (2500 plates /panel):

- NLD1GNS: intended for testing Gr- bacteria: Pasteurellaceae, Enterobacteriales and Pseudomonas.

- NLD1GPS: intended for testing Gr+ bacteria: staphylococci, streptococci, enterococci.

- NLD1MAC: combined plate with macrolides and lincosamides intended for Staphylococci, Streptococci and Pasteurellaceae.

Panel NLD1GNS intended for testing Gram-negative bacteria (Entero’s and Pasteurella)

Panel NLD1GPS intended for testing staphylococci, streptococci and enterococci

Panel NLD1MAC intended for testing both Gram+ and Gram- bacteria

WP3, antimicrobial panels

Three different Sensititre panels (2500 plates /panel):

- 9 European partners- 3 antimicrobials panels (2500 plates)- 10 - 12 antimicrobials/panel- MIC testing of veterinary pathogens- Estimated output: > 50.000 MIC’s!

Physical meeting IMPART:Friday 24 May 8.30 – 10.00

kees.veldman@wur.nl

IMPARTIMPARTIMPARTIMPARTIMPART, WP3�WP leader: Kees Veldman (WBVR)WP3 participantsBackground WP3: ECOFFs EUCAST SOP on MIC distribution and ECOFFsIMPART, WP3IMPART – WP3WP3, �antimicrobial panelsPanel NLD1GNS intended for testing Gram-negative bacteria (Entero’s and Pasteurella)Panel NLD1GPS intended for testing staphylococci, streptococci and enterococciPanel NLD1MAC intended for testing both Gram+ and Gram- bacteriaWP3, �antimicrobial panelsSlide Number 16