Carbapenemase Producing Enterobacterales information

Carbapenemase-producing enterobacterales (CPE) are a strain of the Enterobacteriaceae bacteria family, which naturally live in the gut of humans and animals and help to digest food.

What is CPE?

Carbapenemase-producing enterobacterales (CPE) are a strain of the Enterobacteriaceae bacteria family, which naturally live in the gut of humans and animals and help to digest food. This is called colonisation as it causes no harm and requires no treatment. However, if these bacteria get into other areas of the body, such as the bladder or bloodstream, they can cause infection.

CPE are very resistant to Carbapenems, which are a group of very powerful antibiotics that, until recently, doctors have relied upon to fight infections where treatment with other antibiotics has failed. This makes it very difficult to treat and that is why it is important that CPE is not allowed to spread.

Who is at risk from CPE?

Those people who have been in hospital abroad or in a hospital in the UK .or someone who has been in contact with someone who has had CPE. Transfer from other countries with high prevalence such as Spain, Greece and India.

How do we test for CPE?

If you are at risk of having CPE, you will be offered a screening test on admission. This will involve having a sample taken by a swab from your bottom (rectum). High risk patients such as patients in ICU, renal, haematology/oncology may be required to have 3 screening swabs undertaken, with a 2 day gap between each swab. Stool (poo) samples can also be tested. If necessary, other samples (for example, a urine (wee) sample or a swab from a wound) may be needed.

How can we stop the spread of the bacteria?

If you are found to carry CPE you will be nursed in a single room for your entire stay in hospital.  Staff will wear protective clothing (gloves and long sleeved aprons), when helping you to wash, toilet and dress. This prevents the spread of the bacteria to other people.

It is important for you to wash your hands well with soap and water especially after using the toilet or commode and before eating.

On all other occasions when you need to clean your hands, if your hands look clean, you can also use alcohol hand rub to clean your hands.

It is also important that you avoid touching any medical devices such as urinary catheters or intravenous drips, especially at the point where they enter the body. This will help reduce the risk of developing an infection with CPE. If you require further hospital admissions you will be nursed in a side-room and re-swabbed.

What is the treatment?

Often patients do not require treatment as they do not have any symptoms. However, if your symptoms suggest you have a CPE infection, your doctor may decide to give you treatment.

How can my family and friends protect themselves when visiting?

  • Visitors must wash their hands every time they leave the single room, before eating and after using the toilet.
  • They should not visit if they are feeling unwell or have recently had diarrhoea. Young children and babies should avoid visiting.
  • Visitors should observe any visiting time restrictions in place as these help us to make sure the ward is cleaned thoroughly throughout the day.
  • Visitors should not visit anyone else in hospital at the same time as visiting you so as to avoid spreading any infections.

What you can do

You can help to avoid the transmission of CPE by:

  • washing your hands after using the toilet or commode and before you eat
  • keeping your bed space tidy and uncluttered to make cleaning easier for ward staff
  • asking staff and visitors to wash their hands
  • asking visitors not to sit on your bed (chairs for visitors are available on every ward) or to use patients’ toilets
  • not sharing items with other patients unless they have been cleaned
  • letting the ward staff know if you have had CPE in the past

What precautions are needed at home?

Having CPE will not stop you from going home if you are well. It is important to tell your GP or healthcare provider of your CPE result. We will also inform your GP of your CPE result.

If a relative or friend is caring for you at home, it is important that they wash their hands with soap and water before and after they give care to you. Bed linen, clothes and other laundry items can be washed as normal.

If you have any questions or concerns, please ask your nurse for advice or ask to speak to a member of the Infection Prevention Team.