Download Carbapenem Resistant Enterobacteriaceae

Patients being screened for
Carbapenem Resistant
Enterobacteriaceae (CRE)
What are Carbapenem Resistant Enterobacteriaceae?
There are many bacteria that live naturally and harmlessly in the gut of humans; 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.
Carbapenemase enzymes (chemicals), made by some strains of bacteria, allow the bacteria to
destroy the carbapenem antibiotics. These bacteria are said to be resistant to antibiotics.
Carbapenem resistant Enterobacteriaceae can live harmlessly in the gut; it is referred to as
colonisation if these are found during screening.
Why does Carbapenem resistance matter?
Carbapenem antibiotics can only be given in hospital directly into the bloodstream. Until now,
doctors have relied on them to successfully treat certain serious infections when other
antibiotics have failed to do so.
In a hospital there are many vulnerable patients and the spread of resistant bacteria can cause
problems.
Does colonisation with Carbapenem Resistant Enterobacteriaceae need
treating?
If a person is colonised with Carbapenem resistant Enterobacteriaceae (called CRE), they do
not need to be treated. However, if the bacteria have caused an infection then antibiotics will be
required.
How will I know if I am at risk of being a carrier or having the infection?
Your doctor or nurse may suspect that you are a carrier if you have been in a hospital abroad or
in a UK hospital that has had patients carrying these bacteria, or if you have been in contact
with someone known to have a CRE colonisation or infection.
If any of these reasons apply to you, screening will be arranged for you and you will be cared for
in a single room with your own toilet facilities until the results are known. Staff will wear gloves
and aprons / long sleeved gowns if appropriate when caring for you.
How will I be screened for Carbapenem Resistant Enterobacteriaceae?
Screening can either be a taking a rectal swab inserted just inside your rectum (bottom) or by a
sample of faeces. The swab/sample will be sent to the laboratory and you will normally be
informed of the result within 2 to 3 days.
If the result is negative 2 further swabs/samples will be collected, each 48 hours apart. If these
are also negative you can then be cared for in a bay.
These measures will not hinder your care in any way. If all the results are negative no further
actions are required.
Advice for patients who have a positive result
What happens if the result is positive?
If the result is positive your doctor or nurse will explain this to you in more detail. You will
continue to be cared for in a single room whilst in hospital. If you have an infection, you will be
given antibiotics. However if there are no signs of infection and you are ‘carrying’ the bacteria,
no treatment is required.
How can the spread of Carbapenem Resistant Enterobacteriaceae be prevented?
Caring for you in a single room helps to prevent the spread of the bacteria. Healthcare workers
will decontaminate their hands regularly. They will use long sleeved gowns and gloves 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.
Visitors will be asked to wash their hands on entering and leaving the room and may be asked
to wear gloves and aprons if assisting with personal care. These must be removed after the
episode of care and hands washed.
What about when I go home?
Whilst there is a chance that you may still be colonised when you go home quite often this will
go away with time. No special measures or treatment are required; any infection will have been
treated prior to your discharge.
You should carry on as normal, maintaining good hand hygiene.
Whenever you come into contact with a healthcare professional, e.g. GP, Hospital staff,
ambulance staff, district nurses, it is important that you make them aware of the CRE result.
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 with CRE previously.
Where can I find more information?
If you would like further information please speak to a member of your care staff, who will
contact the Infection Prevention and Control Team for you.
The Public Health England website is another source of information:
www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/CarbapenemResistance/
September 2014 © Copyright 2014 All rights reserved. No part of this publication may be reproduced in any form or by any means without prior
permission in writing from Infection Control, Derby Hospitals NHS Foundation Trust.