{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:20:15Z","timestamp":1785417615984,"version":"3.56.0"},"reference-count":24,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2025,8,13]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The purpose of this study was to establish tentative Clinical and Laboratory Standards Institute (CLSI) M45 MIC and disk diffusion (DD) breakpoints (BPs) for\n                      <jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>\n                      other than\n                      <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                      (POPA). Mechanisms of antimicrobial resistance (AMR) and the modified carbapenem inactivation method (mCIM) to detect carbapenemase production were also evaluated. MIC data from\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      and POPA from 2013 to 2022 were evaluated to compare the MIC distributions and modal MICs relative to the CLSI M100\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      BPs. A disk-to-MIC correlation study with 83 isolates was completed by testing reference broth microdilution and DD from the same inoculum, and the error-rate bounded method was used to establish DD BPs. For most antimicrobials, the modal MICs between\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      and POPA were within 1-doubling dilution and lower than the M100\n                      <jats:italic toggle=\"yes\">P. aeruginosa-<\/jats:italic>\n                      susceptible BP. For amikacin, the modal MIC for POPA was 2-doubling dilutions lower than\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      and was evaluated relative to the Enterobacterales BP. For aztreonam and trimethoprim-sulfamethoxazole, the modal MICs were elevated, and no BPs were set. New DD correlates were established for most antimicrobial agents, except for fluoroquinolones, where the\n                      <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                      correlates were suitable. AMR genes conferring resistance to multiple antimicrobial classes were identified by WGS. Beta-lactamase genes were identified in 30 (36.1%) isolates, with metallo-beta-lactamases (90.6%) predominating. The mCIM had a sensitivity and specificity of 100%. Upon review, the CLSI M45 committee proposed tentative MIC and DD BPs for expanded-spectrum cephalosporins (ceftazidime and cefepime), carbapenems (meropenem and imipenem), fluoroquinolones (ciprofloxacin and levofloxacin), and the aminoglycosides (amikacin and tobramycin).\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>\n                        <jats:bold>IMPORTANCE<\/jats:bold>\n                      <\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>\n                        species other than\n                        <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                        (POPA) can cause opportunistic infections which may be difficult to treat due to a variety of antimicrobial resistance mechanisms. Antimicrobial susceptibility testing is a critical component of patient management for these infections. Currently, the Clinical and Laboratory Standards Institute (CLSI) M100 non-Enterobacterales breakpoints and methodology are utilized for POPA by US clinical laboratories and likely do not accurately predict susceptibility results. The purpose of this study was to establish tentative CLSI M45 MIC and disk diffusion breakpoints for POPA. Mechanisms of antimicrobial resistance and the modified carbapenem inactivation method to detect carbapenemase production were also evaluated. We present the data used by the volunteers tasked by CLSI to develop POPA breakpoints in the M45 guidelines.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.00368-25","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T09:00:42Z","timestamp":1751274042000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Establishing Clinical and Laboratory Standards Institute M45 antimicrobial susceptibility testing methods and breakpoints for\n                    <i>Pseudomonas<\/i>\n                    other than\n                    <i>Pseudomonas aeruginosa<\/i>"],"prefix":"10.1128","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6134-151X","authenticated-orcid":true,"given":"Patricia J.","family":"Simner","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic","place":["Rochester, USA"]},{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harley","family":"Harris","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Jacobs","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haley","family":"Stambaugh","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira","family":"Bhalodi","sequence":"additional","affiliation":[{"name":"Scientific and Medical Affairs Consulting LLC","place":["Newton, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Fisher","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03r0ha626","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Utah and ARUP Laboratories","place":["Salt Lake City, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsigereda","family":"Tekle","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Lu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00za53h95","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6568-156X","authenticated-orcid":true,"given":"Romney","family":"Humphries","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05dq2gs74","id-type":"ROR","asserted-by":"publisher"}],"name":"Vanderbilt Medical Center University","place":["Nashville, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","volume-title":"Manual of clinical microbiology","author":"Carroll KC","year":"2023","unstructured":"Carroll KC, Pfaller MA, American Society for Microbiology. 2023. Manual of clinical microbiology. 13th ed. Wiley, Hoboken, NJ.","edition":"13"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01595-19"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/bjbs.2022.10468"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.syapm.2021.126289"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001258"},{"key":"e_1_3_4_7_2","unstructured":"U.S. Food and Drug Administration. 2024. FDA-recognized antimicrobial susceptibility test interpretive criteria. Secondary FDA-recognized antimicrobial susceptibility test interpretive criteria. Available from: https:\/\/www.fda.gov\/drugs\/development-resources\/fda-recognized-antimicrobial-susceptibility-test-interpretive-criteria"},{"key":"e_1_3_4_8_2","volume-title":"Methods for antimicrobial dilution and disk susceptibility testing of infrequently isolated or fastidious bacteria","author":"CLSI","year":"2016","unstructured":"CLSI. 2016. Methods for antimicrobial dilution and disk susceptibility testing of infrequently isolated or fastidious bacteria. M45-ED3 ed. Clinical and Laboratory Standards Institute, Wayne, PA.","edition":"45"},{"key":"e_1_3_4_9_2","volume-title":"Performance standards for antimicrobial susceptibility testing","author":"CLSI","year":"2024","unstructured":"CLSI. 2024. Performance standards for antimicrobial susceptibility testing. 34 ed. Clinical and Laboratory Standards Institute.","edition":"34"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00264-25"},{"key":"e_1_3_4_11_2","volume-title":"European Committee on Antimicrobial Susceptibility Testing Breakpoint Tables for interpretation of MICs and zone diameters","author":"EUCAST","year":"2025","unstructured":"EUCAST. 2025. European Committee on Antimicrobial Susceptibility Testing Breakpoint Tables for interpretation of MICs and zone diameters. 15th ed","edition":"15"},{"key":"e_1_3_4_12_2","volume-title":"Development of in vitro susceptibility test methods, breakpoints, and quality control parameters","author":"CLSI","year":"2023","unstructured":"CLSI. 2023. Development of in vitro susceptibility test methods, breakpoints, and quality control parameters. 6th ed. Clinical and Laboratory Standards Institute.","edition":"6"},{"key":"e_1_3_4_13_2","volume-title":"Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically","author":"CLSI","year":"2024","unstructured":"CLSI. 2024. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. 12th ed. Clinical and Laboratory Standards Institute.","edition":"12"},{"key":"e_1_3_4_14_2","volume-title":"Performance standard for antimicrobial disk susceptibility testing","author":"CLSI","year":"2024","unstructured":"CLSI. 2024. Performance standard for antimicrobial disk susceptibility testing. 14th ed. Clinical and Laboratory Standards Institute.","edition":"14"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2006.01377.x"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00193-17"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01369-17"},{"key":"e_1_3_4_18_2","unstructured":"Hagey JV Kent AG Diaz M Halpin AL. 2023. CDCgov\/phoenix: v2.0.0. Secondary CDCgov\/phoenix: v2.0.0. Available from: https:\/\/github.com\/CDCgov\/phoenix"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03264-15"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11274-013-1295-3"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01062-10"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00338-5"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01809-20"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1099\/ijsem.0.003623"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s42770-022-00857-4"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00368-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00368-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T13:00:49Z","timestamp":1755090049000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.00368-25"}},"subtitle":[],"editor":[{"given":"Erin","family":"McElvania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8,13]]}},"alternative-id":["10.1128\/jcm.00368-25"],"URL":"https:\/\/doi.org\/10.1128\/jcm.00368-25","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]},"assertion":[{"value":"2025-02-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00368-25"}}