The Epsilometer test (usually abbreviated Etest) is a laboratory test used by microbiologists to determine whether or not a specific strain

of bacterium or fungus is susceptible to the action of a specific antibiotic. This is most commonly used in the setting of medicine, where a particular organism has been found to infect a patient, and the doctor treating the patient is seeking guidance on what concentration of antibiotic is suitable. The principle of the epsilometer test was first described in 1988 and was introduced commercially in 1991 by AB Biodisk . The Etest is basically an agar diffusion method. The Etest utilizes a rectangular strip that has been impregnated with the drug to be studied. A lawn of bacteria is spread and grown on an agar plate, and the Etest strip is laid on top; the drug diffuses out into the agar, producing an exponential gradient of the drug to be tested. There is an exponential scale printed on the strip. After 24 hours of incubation, an elliptical zone of inhibition is produced and the point at which the ellipse meets the strip gives a reading for the minimum inhibitory concentration (MIC) of the drug. The test has been validated for many organisms against the broth/agar dilution method and shown to have excellent correlation. This is a partial list of organisms and antibiotics for which the test has been validated. Pseudomonas aeruginosa: amikacin, ceftazidime, gentamicin, piperacillin, ticarcillin, tobramycin The following list (in alphabetical order) reflects Etest strips available in the Uni ted States for in vitro diagnostic use (as of Jan 2010): Amikacin, Amoxi/clav, Amoxicillin, Ampicil/sulb, Ampicillin, Azithromycin, Aztreonam, Benzylpenicillin (32 and 256 ug/ml), Cefaclor, Cefepime, Cefotaxime (32 and 256 ug/mL), Cefotetan, Cefoxotin, Ceftazadime, Ceftizoxime, Ceftriaxone, Cefuroxime, Cephalothin, Chloramphenicol, Ciprofloxacin, Clindamycin, Dapto mycin, Doripenem, Ertapenem, Erythromycin, Fosfomycin, Gatifloxacin,Gemifloxacin, Gentamicin (256 and 1024 ug/mL), Imipenem, Levofloxacin, Linezolid, Meropenem, Metronidazole, Minocycline, Moxifloxacin , Ofloxacin, Oxacillin, Pip/Tazo,Piperacillin, Quinupri/Dalfopri, Rifampicin, Ticar/Clav, Tigecycline, Trim/Sulfa, Trimethoprim, Vancomycin, Etest for Antifungal Susceptibility Testing Fluconazole, Itraconazole, Flucytosine, Voriconazole Etest for Extended spectrum beta-lactamase Detection Cefotaxime/Clav. acid, Ceftazidime/Clav. acid

Etest is a well-established method for antimicrobial resistance testing in microbiology laboratories around the world. Etest consists of a predefined gradient of antibiotic concentrations on a plastic strip and is used to determine the Minimum Inhibitory Concentration (MIC) of antibiotics, antifungal agents and anti-mycobacterial agents. Etest is a well-established method for antimicrobial resistance testing that brings on-scale MIC testing to all microbiology laboratories. Etest promotes the rational use of antibiotics by providing results to guide the therapy of individual patients and to validate empiric drug regimens. It is particularly helpful in determining choice and dosage of antimicrobials in patients with sterile site infections (e.g. endocarditis), severe nosocomial infections, chronic infections (e.g. cystic fibrosis) and immunosuppressed patients. Etest is also widely used in resistance surveillance programs and clinical trials. Storage Container Dimensions (601603) Height: 90 mm Diameter: 55 mm Weight: 30 grams For clinical laboratories: Provides Minimum Inhibitory Concentrations (MICs) for slow-growing and fastidious organisms that have unique growth requirements and cannot be testing by automated methods Antibiotic susceptibility testing (AST) and resistance mechanism detection Testing robust aerobes, anaerobes, pneumococci, meningococci and fastidious organisms such as the HACEK group, Bordatella and Francisella Detect phenotypic resistance For clinicians and administrators: Provides Minimum Inhibitory Concentrations (MICs) for slow-growing and fastidious organisms that have unique growth requirements and cannot be testing by automated methods Antibiotic susceptibility testing (AST) and resistance mechanism detection Improve antibiotic stewardship Reduce possibility of adverse drug events due to unnecessary therapy Validate susceptibility results and minimize the possibility of erroneous results due to laboratory error Guide antibiotic selection and dosing Improve patient outcome and lower healthcare-associated expenses Decrease hospital length of stay and associated costs of prolonged hospitalization For Veterinary Labs: Manual antibiotic susceptibility testing

Etest is a predefined, stable gradient of 15 antibiotic concentrations on a plastic strip. Using innovative dry chemistry technology, Etest is used to determine the on-scale Minimum Inhibitory Concentration (MIC) of antibiotics, antifungal agents and anti-mycobacterial agents. Etest is recognized as a cost-effective tool for generating MICs across 15 dilutions. Over 100 antimicrobials are now available in the product range for testing of aerobic bacteria and fastidious organisms* such as Pneumococci, Haemophilus, H. pylori, Meningococci, Gonococci, Anaerobes, Fungi and Mycobacteria. Etest can help you Determine the MIC of fastidious, slow-growing or nutritionally deficient micro-organisms, or for a specific type of patient or infection. Confirm/detect a specific resistance phenotype e.g. ESBL, MBL, AmpC or GISA/hGISA. Detect low levels of resistance. Test an antimicrobial not performed in routine use or a new, recently introduced antimicrobial agent. Confirm an equivocal AST result. Which clinical situations benefit most from Etest? Etest provides high medical value to: Refine or guide treatment decisions. Promote antibiotic stewardship. Determine the choice and dosage of antimicrobials in patients (PK/PD) with sterile site infections ( e.g. endocarditis), severe nosocomial infections, chronic infections (e.g. cystic fibrosis) and immunosuppressed patients.

Easy-to-Use Apply the strip to an inoculated agar plate either manually or using the instruments and incubate. After incubation, an ellipse will appear that intersects the MIC value scale (in g/ml) where the concentration of the antibiotic tested inhibits microorganism growth. This value corresponds to the MIC that can be used to help chose optimum patient treatment.

In microbiology, minimum inhibitory concentration (MIC) is the lowest concentration of an antimicrobial that will inhibit the visible growth of a microorganism after overnight incubation. Minimum inhibitory concentrations are important in diagnostic laboratories to confirm resistance of microorganisms to an antimicrobial agent and also to monitor the activity of new antimicrobial agents. [1] A lower MIC is an indication of a better antimicrobial agent. A MIC is generally regarded as the most basic laboratory measurement of the activity of an antimicrobial agent against an organism. MICs can be determined by agar or broth dilution methods usually following the guidelines of a reference body such as the CLSI, BSAC or EUCAST. There are several commercial methods available, including the well-established Etest strips and the recently launched Oxoid MIC Evaluator method. The Etest system comprises a predefined and continuous concentration gradient of different antimicrobial agents, which when applied to inoculated agar plates and incubated, create ellipses of microbial inhibition. The MIC is determined where the ellipse of inhibition intersects the strip, and is easily read off the MIC reading scale on the strip. Clinically, the minimum inhibitory concentrations are used not only to determine the amount of antibiotic that the patient will receive but also the type of antibiotic used, which in turn lowers the opportunity for microbial resistance to specific antimicrobial agents. Currently, there are a few web-based, freely accessible MIC databases.