Carbapenamase producing enterobacterales (CPE)

What does carbapenemase producing Enterobacterales (CPE) mean?

Enterobacterales are bacteria that usually live harmlessly in the gut of humans. This is called‘colonisation’ (a person is said to be a ‘carrier’). However, if the bacteria get into the wrong place, such as the bladder or bloodstream they can cause infection. Carbapenems are one of the most powerful types of antibiotics. Carbapenemases are enzymes, made by some strains of these bacteria, which allow them to destroy carbapenem antibiotics and so the bacteria are said to be resistant to the antibiotics.

Why does carbapenem resistance matter?

Doctors have relied on carbapenem antibiotics to successfully treat certain complicated infections when other antibiotics have failed to do so. In a hospital, where there are many vulnerable patients, spread of resistant bacteria can cause problems.

Does carriage of CPE need to be treated?

If a person is a carrier of CPE, there will be no symptoms and they do not need to be treated.

However, if the bacteria have caused an infection then antibiotics will be required.

How did I ‘pick up’ CPE?

This bacteria can be found, living harmlessly, in the gut of humans and so it can be difficult to say when or where you picked it up. However, there is an increased chance of picking up these bacteria if you have been a patient in a hospital abroad or in a UK hospital that has had patients carrying the bacteria, or if you have been in contact with a carrier elsewhere.

How will I be cared for whilst in hospital?

You will be accommodated in a single room with toilet facilities whilst in hospital. You may be asked to provide a number of samples, depending on your length of stay, to check if you are still carrying the bacteria. The samples might include a number of swabs from certain areas, such as, a rectal swab i.e. a sample taken by inserting a swab briefly just inside your rectum (bottom), and / or a faecal sample. You will normally be informed of the results within two to three days.
 

How can the spread of CPE be prevented?

Accommodating you in a single room helps to prevent spread of the bacteria.

Healthcare workers should clean their hands regularly with soap and water or a hand sanitiser. They will use gloves and aprons when caring for you.

The most important measure for you to take is to wash your hands well with soap and water, especially after going to the toilet.

You should avoid touching medical devices (if you have any) such as your urinary catheter tube and your intravenous drip, particularly at the point where it is inserted into the body or skin.

Visitors will be asked to wash their hands on entering and leaving the room and may be asked to wear an apron.

What about when I go home?

Whilst there is a chance that you may still be a carrier when you go home quite often this will go away with time. No special measures or treatment are required. You should carry on as normal, maintaining good hand hygiene, especially after using the toilet or preparing food.

CPE can be removed from surfaces using normal household disinfectants and disposable cloths.

Clothes, bedding and linen can be washed as normal using your usual detergent product at the hottest temperature recommended for the fabric.

If you have any concerns you may wish to contact your GP for advice.

If you are admitted to another hospital, you should let the hospital staff know that you are or have been a carrier.

If you would like any further information you can speak to a member of the Infection Prevention and Control Team (ext 1326/1057).

The UK Health Security Agency website is another source of information.