Carbapenemase-producing Enterobacteriaceae (CPE)
You have been told that you are colonised or have an infection with Carbapenemase-producing Enterobacteriaceae (CPE). The information in this leaflet answers the commonly asked questions.
What does CPE mean?
Enterobacteriaceae (also known as coliforms) are bacteria that usually live harmlessly in the gut of humans and other animals. This is called colonisation. However, if the bacteria get into the wrong place, such as the bladder or the bloodstream, they can cause infection.
Carbapenems are one of the most powerful types of antibiotics used to treat infections caused by Enterobacteriacae. They are only used if other commonly used and less powerful antibiotics are not effective. Unfortunately, some Enterobacteriacae have developed resistance to these antibiotics. They do so by producing enzymes called Carbapenemases which destroy these antibiotics making them ineffective. Worryingly, CPEs are often resistant to other commonly used antibiotics such as quinolones and aminoglycosides. It is therefore very difficult to treat infections caused by these bacteria.
Why do CPEs matter?
As mentioned before, there are very limited options for treating infections caused by CPE.
In a hospital where there are many vulnerable patients, the spread of CPE can cause problems.
Does colonisation with CPE need to be treated?
If a person is colonised with CPE, they do not need to be treated. However, they need to be isolated to prevent the spread of CPE to other patients. If the CPE cause an infection, they will need to be treated with antibiotics.
How did I pick up CPE?
This bug can be found living harmlessly in the gut of humans, so it can be difficult to say when or where you picked it up. However, there is an increased chance of picking up these bugs if you have been a patient in a hospital abroad, in a hospital in this country that has had patients carrying this bug, or if you have been in contact with a carrier elsewhere. If you wish you can ask your doctor or nurse to explain this to you in more detail.
How will I be cared for while in hospital?
You will be staying in a single room with toilet facilities while in hospital. You may be asked to provide a number of samples, depending on your length of stay. This is to check if you are still carrying the bugs. These samples will be taken on a weekly basis.
The samples might include a number of swabs from certain areas, such as where the tube for your drip (if you have one) enters the skin, a rectal swab, i.e. a sample taken by inserting a swab briefly just inside your rectum (bottom), and or a faecal (stool) sample. You will normally be informed of the results within 2 to 3 days.
How can the spread of CPE be prevented?
Being cared for in a single room will help to prevent the spread of CPE. Healthcare workers will use gloves and aprons or gowns when caring for you. They will clean their hands after taking off their gloves and aprons.
You must wash your hands well with soap and water, especially after going to the toilet. You should avoid touching medical devices such as your urinary catheter tube (if you have one) and your intravenous drip, particularly at the point where it is inserted into your body or skin.
Visitors will be asked to wash their hands on entering and leaving your room and may be asked to wear an apron.
What happens when I go home?
While 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 will be needed as any infection will have been treated before your discharge.
You should carry on maintaining good hand hygiene. If you have any concerns when you go home please contact your GP for advice.
Before you leave hospital, you will be given an ‘alert card’ for CPE. This card will be useful for the future if you need healthcare treatment as it is important that you make health care staff aware.
Should you or a member of your household be admitted to hospital, you should let the hospital staff know that you are, or have been colonised or infected with CPE in the past and show them the card. The card will remind staff of the need to check whether you are still a carrier by taking swabs and that appropriate infection control measures are taken while you are in hospital. Members of your household may need to be screened for CPE if they are admitted to hospital.