The European Committee on Antimicrobial Susceptibility Testing (EUCAST) Organization

image courtesy of www.eucast.org

The European Committee on Antimicrobial Susceptibility Testing (EUCAST) is a standing committee jointly organized by European Society of Clinical Microbiology and Infectious Disease (ESCMID), European Centre for Disease Prevention and Control (ECDC) and European national breakpoint committees. EUCAST deals with breakpoints and technical aspects of phenotypic in vitro antimicrobial susceptibility testing and functions as the breakpoint committee of EMA and ECDC. EUCAST does not deal with antibiotic policies, surveillance or containment of resistance or infection control. The Steering Committee is the decision making body. It is supported by a General Committee with representatives from European and other countries, FESCI and ISC. The Steering Committee also consults on EUCAST proposals with experts within the fields of infectious diseases and microbiology, pharmaceutical companies and susceptibility testing device manufacturers.

EUCAST has a subcommittee on antifungal susceptibility testing and on methods for detection of resistance mechanisms of clinical and/or epidemiological importance.

Subcommittees on expert rules for antimicrobial susceptibility testing and antimicrobial susceptibility testing of anaerobes have completed their tasks and have been disbanded.

Most antimicrobial MIC breakpoints in Europe have been harmonised by EUCAST. Breakpoints for new agents are set as part of the licensing process for new agents through EMA. EUCAST breakpoints are available in devices for automated susceptibility testing but with some limitations, depending on the system. A disk diffusion susceptibility test method calibrated to EUCAST MIC breakpoints is also available.

EUCAST invites anyone with an interest in antimicrobial agents in general and antimicrobial breakpoints in particular to contact EUCAST, ESCMID or one of the National Breakpoint Committees.

EUCAST objectives 

• To form in EUCAST, under the auspices of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC), a network of established experts in the determination of antimicrobial breakpoints and in antimicrobial susceptibility testing. 
• To determine, review and revise European clinical breakpoints and epidemiological cut-off values for surveillance of antimicrobial resistance in close collaboration with the European Medicines Agency (EMA) and ECDC. 
• To promote the development and standardization of in-vitro antimicrobial susceptibility testing methods used in Europe. 
• To promote quality assurance of in-vitro antimicrobial susceptibility testing. 
• To promote education and training in antimicrobial susceptibility testing. 
• To advise ECDC and other European Union health agencies on issues related to antimicrobial susceptibility testing and detection of resistance determinants relevant to public health. 
• To collaborate with international groups, ECDC and other European Union health agencies involved in antimicrobial susceptibility testing and/or the epidemiology of antimicrobial resistance in human pathogens. 
• To work towards international consensus and harmonization of clinical breakpoints and antimicrobial susceptibility testing. 

EUCAST membership 

• Steering Committee- ESCMID appoints the Chairman, Scientific Secretary and Clinical Data Coordinator. ESCMID decides on 4-6 members representing National Antimicrobial Susceptibility Testing Committees (NACs) with experience in determining breakpoints (currently France, Germany, Norway, Sweden, the Netherlands and the UK) and on 2-4 members from the EUCAST General Committee. All Steering Committee members serve for 2 years and may be reappointed. Those representing the General Committee may not be reappointed for consecutive periods unless there are no other applicants. Expertise in breakpoint setting, antimicrobial resistance, susceptibility testing, pharmacokinetics and pharmacodynamics must be guaranteed. Observers from ECDC and EMA are free to attend Steering Committee meetings. 
• General Committee- The General Committee consists of one representative from each European country and each country outside Europe interested in advocating and developing EUCAST guidelines. Countries that have formally applied through their NAC or a national society of clinical microbiology and/or infectious diseases and/or medicine are appointed to the General Committee. Representatives of ECDC and EMA will be ex officio General Committee members. 

New applications to the EUCAST General Committee and Steering Committee are tendered at least one month prior to the annual General Committee meeting. 

EUCAST Subcommittees 

The Steering Committee may establish ad-hoc subcommittees to work towards achieving specific objectives of EUCAST. The subcommittees will work to a defined remit and timescale. 

EUCAST Decisions 

• EUCAST proposals will, unless restricted by confidentiality agreements, be distributed for consultation to EUCAST General Committee members and to EUCAST email networks. 
• EUCAST proposals for breakpoints as part of the approval process of new drugs will only be disclosed to the applicant and to EUCAST Steering Committee members who have signed a confidentiality agreement (when such an agreement has been required). 
• The Steering Committee will make final decisions. 
• EUCAST will maintain email address lists of (i) expert groups, (ii) individual experts in specific fields, (iii) contacts at pharmaceutical companies and (iv) contacts at companies marketing antimicrobial susceptibility testing devices. These groups will be consulted on and informed of EUCAST activities as appropriate. Email network contacts at pharmaceutical companies and companies marketing antimicrobial susceptibility testing devices are responsible for provision of their current contact details. 

EUCAST breakpoints for new antimicrobial agents 

Through an agreement between the EMA, pharmaceutical industry and EUCAST, the role of EUCAST with respect to breakpoint determination is recognised as part of the official EMA process for approval of new antimicrobial agents (see EMA SOP/H/3043 14 February 2005, revised 23 January 2007). Only the applicant of the specific product under consideration will be part of the process, as outlined in the EMA SOP/H/3943 (Click here to view). 

EUCAST Meetings 

• A EUCAST Annual General Meeting will be held in conjunction with the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). The Annual General Meeting will be an open meeting. 
• The Steering Committee will meet as often as necessary, normally 4-5 times per year. 

EUCAST Publications 

As appropriate, documents will be submitted for publication in scientific journals. All EUCAST documents will be posted on the EUCAST website (www.eucast.org).

Declaration of commercial interests by EUCAST Steering Committee members 

Each Steering Committee member will make a declaration of commercial interests in companies involved in drug marketing and/or development or in the manufacture of susceptibility testing products. The declarations will be made/updated at the start of each two-year term of office. Any new interests relating to current discussions must be declared by the individual member. The declarations will be held by the Chairman and will be presented on request. Steering Committee members will excuse themselves from discussions on issues where a conflict of interest exists and this will be noted in minutes. 

EUCAST funding 

The activities of EUCAST are jointly supported financially by ESCMID and ECDC based on appropriate contractual arrangements. The employers of Steering Committee members support the work of EUCAST by allowing employees to take part in EUCAST activities as agreed between the employer and the employee. Financial support from industry is not accepted for the work of EUCAST committees or subcommittees.

For more details about EUCAST, please visit their official website www.eucast.org