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1 May 2007

Volume 44, Number 9
Clinical Infectious Diseases 2007;44:1208–1215
© 2007 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2007/4409-0012$15.00
DOI: 10.1086/513203
VIEWPOINTS

The Rationale for Revising the Clinical and Laboratory Standards Institute Vancomycin Minimal Inhibitory Concentration Interpretive Criteria for Staphylococcus aureus

Fred C. Tenover1 and

Robert C. Moellering, Jr.2

1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and 2Beth Israel Deaconess Medical Center, Boston, Massachusetts

The Clinical and Laboratory Standards Institute (formerly, the NCCLS) established the susceptibility and resistance breakpoints for minimal inhibitory concentration (MIC) and disk diffusion testing of vancomycin against isolates of Staphylococcus aureus >20 years ago. The disk diffusion breakpoints were modified in 1998 when it was recognized that vancomycin‐intermediate S. aureus strains were not detected by this method. In 2006, the vancomycin MIC breakpoints for S. aureus were lowered (from 4 μg/mL to 2 μg/mL for “susceptible,” from 8–16 μg/mL to 4–8 μg/mL for “intermediate,” and from 32 μg/mL to 16 μg/mL for “resistant”) to increase detection of heterogeneously resistant isolates of S. aureus. This decision reflected a growing amount of microbiological and clinical data indicating that isolates of S. aureus are less likely to respond to vancomycin therapy when the vancomycin MICs are 4μg/mL.

Received 7 November 2006; accepted 1 January 2007; electronically published 28 March 2007.

Reprints or correspondence: Dr. Fred C. Tenover, Div. of Healthcare Quality Promotion, Centers for Disease Control and Prevention (G‐08), 1600 Clifton Rd., Atlanta, GA 30333 ().

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  • The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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