CDC Model Performance Evaluation Program (MPEP) for Mycobacterium tuberculosis
Drug Susceptibility Testing
Attachment 9
MPEP Mycobacterium tuberculosis Minimum Inhibitory Concentration (MIC)
Results Worksheet
MPEP Mycobacterium tuberculosis Minimum Inhibitory Concentration (MIC)
Results Worksheet
Enter your categorical drug susceptibility test result interpretation and minimum inhibitory concentration (MIC) for each isolate tested by Sensititre by using the data worksheet below. For laboratories who customize Sensititre plates, please use ‘Other’ for any additional antituberculosis drugs tested.
This worksheet is provided as a tool for recording results prior to online data entry.
MPEP Number Isolate
Drug |
Resistant |
Susceptible |
Intermediate |
Contaminated/ No Growth |
No Interpretation |
Not Done |
MIC (µg/ml) |
Rifampin |
|
|
|
|
|
|
|
Isoniazid |
|
|
|
|
|
|
|
Ethambutol |
|
|
|
|
|
|
|
Streptomycin |
|
|
|
|
|
|
|
Ofloxacin |
|
|
|
|
|
|
|
Ciprofloxacin |
|
|
|
|
|
|
|
Moxifloxacin |
|
|
|
|
|
|
|
Levofloxacin |
|
|
|
|
|
|
|
Amikacin |
|
|
|
|
|
|
|
Kanamycin |
|
|
|
|
|
|
|
Capreomycin |
|
|
|
|
|
|
|
Ethionamide |
|
|
|
|
|
|
|
Rifabutin |
|
|
|
|
|
|
|
Cycloserine |
|
|
|
|
|
|
|
Para-aminosalicylic Acid |
|
|
|
|
|
|
|
Rifapentine |
|
|
|
|
|
|
|
Bedaquiline |
|
|
|
|
|
|
|
Linezolid |
|
|
|
|
|
|
|
Clofazamine |
|
|
|
|
|
|
|
Delamanid |
|
|
|
|
|
|
|
Pretomanid |
|
|
|
|
|
|
|
Other: __________ |
|
|
|
|
|
|
|
Other: __________ |
|
|
|
|
|
|
|
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Yakrus, Mitchell (CDC/OID/NCHHSTP) |
| File Modified | 0000-00-00 |
| File Created | 2021-12-16 |