Antimicrobial Susceptibility Testing (AST) system

NHS Scotland requires a standard Antimicrobial Susceptibility Testing (AST) system to be used across all 15 NHS Health Boards which provide a Clinical Microbiology service: from multi-disciplinary laboratories in remote / rural Boards to large laboratories providing specialist services in tertiary referral Boards. The AST solution must be (semi-) automated and up-scalable so that it is practical for both small and large laboratories and it must have a proven real-world performance record.

Please note interest by 22nd July 2025 NHS Scotland requires a standard Antimicrobial Susceptibility Testing (AST) system to be used across all 15 NHS Health Boards which provide a Clinical Microbiology service: from multi-disciplinary laboratories in remote / rural Boards to large laboratories providing specialist services in tertiary referral Boards.

The AST solution must be (semi-) automated and up-scalable so that it is practical for both small and large laboratories and it must have a proven real-world performance record. The national AST system must deliver panel testing for both bacteria and fungi.

Suppliers are requested to provide details of the antibiotics, organisms and “drug-bug” combinations which may be tested on their system as well as those which cannot be tested on their system. It is essential that NHS Scotland-bespoke testing panels are available and that the system is fully EUCAST compliant, in line with Scottish AMR surveillance requirements.

Annual EUCAST updates must be available on the system within six months of publication, including breakpoints and interpretive criteria. In the absence of specific EUCAST “drug-bug” testing and interpretive criteria, alternatives stipulated by the SMVN (e.g. CLSI) must be incorporated into the testing system.

If the supplier’s system is capable of delivering “rapid AST (RAST)”, details should be provided. A bi-directional interface between the AST system and each Board’s Laboratory Information Management System (LIMS) is essential and implementation should be led by the AST system supplier.

The national AST solution must routinely report minimum inhibitory concentration (MIC) data as well interpreted MICs via system software to routinely report antibiograms and ensure unusual phenotypes are highlighted. The ability to search and produce management reports on AST data would be advantageous and details should be provided.

AST equipment is expected to have a lifespan of a minimum of 7 to 10 years. Suppliers are asked to submit details of [a] their standard (semi-) automated AST equipment currently available for all 15 NHS Scotland Boards that deliver an AST service, [b] details of standard testing panels currently available, [c] interpretive criteria, [d] reportable patient results and [e] epidemiological packages, if available.

Prerequisites and dependence on any additional or ancillary equipment / systems should be highlighted. Suppliers are asked to describe the system(s) available to fulfil this national requirement and also provide a (maximum) 2 page summary detailing the service that would be provided. Indicative numbers of ASTs carried out per year in NHS Scotland laboratories are (average 2018 – 2024): Average AST tests per year: 100,000 - 1 Health Board