Antimicrobial susceptibility testing of bacteria and fungi and antimicrobial resistance surveillance are closely linked together. The latter is heavily dependant on the former. There is an urgent need for European standardization and harmonization of breakpoints and reference methodology for antimicrobial susceptibility testing. Project vision: In accordance with the council recommendations 2002/77/EC, to create a pan-European network (the EUCAST General Committee) and a European standing committee (EUCAST Steering committee) with the objectives to harmonize European clinical MIC breakpoints for antibacterial and antifungal drugs and to define epidemiological cut-off values for the early detection and measurement and international comparison of antimicrobial resistance development. Furthermore, to create an interactive web-based system for the collection of MIC-values and the display of reference wild type distributions of MIC-values to be used for methodological standardization and for breakpoint setting; to offer liaison with and expertise to European dedicated surveillance networks and European regulatory bodies, and to take initiatives within education in the respective fields.

This project has been designed to meet council recommendation (2002/77/EC) "to propose common methodology, case definitions and nature and type of data to be collected for the surveillance on the susceptibility of pathogens resistant to antimicrobial agents".
The project contributes to policy development at EU level since it harmonises the basic data needed for treatment of patients and gives European dedicated surveillance networks a common basis for interpreting antimicrobial resistance data. Finally, it provides European added value since the results of the project are designed for implementation in all European countries.

There are six active national breakpoint committees in Europe 2003 (Germany, France, Norway, Sweden, The Netherlands, The United Kingdom) each with a long tradition of determining breakpoints for antimicrobial susceptibility testing and each upholding a national system for antimicrobial susceptibility testing. The project was intended to (1) create a European network of existing national breakpoint committees, (2) create common epidemiological cut-off values for early detection of resistance development and for cross-border comparison of antimicrobial resistance; (3) harmonize existing national clinical breakpoints in Europe through a systematic inter-committee-collaboration agreed upon by all six national breakpoint committees (mentioned above), (4) seek European consensus on the new European breakpoint systems described (a) through the EUCAST general committee on which all European countries have a seat, (b) through yearly progress workshops inviting all European countries to participate, (c) through two websites under development: an official EUCAST website http://www.eucast.org and a website collecting and displaying large amounts of internationally accepted MIC-data to be used as a reference database for calibration of methodology and for displaying new epidemiological cut-off values and harmonized European clinical breakpoints.

- European harmonised clinical breakpoints for antimicrobial agents, including drugs for fungal infections. - European epidemiological cut-off values for the measurement of acquired antimicrobial resistance and facilitation of an early warning system for emergence of resistance. - The publication of reference methodology for antimicrobial MIC-determination in agar and broth. - The publication of reference methodology on internal and external quality control and assessment of antimicrobial susceptibility testing. - The setting up and operation of two websites – one for recommendations in the field of antimicrobial susceptibility testing, the other a reference database of MIC-distributions of wild-type bacteria. - The implementation of the above through two workshops for national representatives of member states, applicant states and future would be EU-members, and in collaboration with the EARSS network. - Expert liaison (breakpoint and QA) with the EARSS management team.