Download Carbapenemase-producing Enterobacteriaceae (CPE)

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Enterobacteriaceae (CPE)
CPE stands for carbapenemase-producing Enterobacteriaceae. There are groups of
bacteria (germs) that produce carbapenemases (chemicals). These chemicals can
destroy antibiotics called carbepenems. This makes the bacteria resistant to the
antibiotic. Carbapenems are a powerful group of antibiotics that are often relied on
for infections where treatment with other antibiotics has failed. So preventing the
spread of CPE in our hospitals will make sure that these antibiotics continue to be
available to treat infections in the future.
CPE can live in the gut of humans and animals and they help us to digest food. In
most cases CPE are harmless and cause no ill effects – this is called colonisation. If
the bacteria get into the body (for example, into the bloodstream or urinary tract),
they can cause infection. This can happen if you are unwell or have a weakened
immune system.
How do we diagnose the condition?
If you need a sample to be taken for testing, a member of your care team will
discuss this with you. Normally a rectal swab is taken. A member of your care team
will gently insert a swab a small distance into your rectum (bottom). Or, they may
test a sample of faeces. Some other samples may be needed, for example a wound
swab or urine sample. You should not experience any discomfort while samples or
swabs are taken. Your privacy and dignity will be respected at all times when these
samples are taken.
All swabs and samples will be sent to the laboratory to see which bacteria grow and
your care team will tell you the results. The results can take approximately one to
three days. You may be cared for in a single room until the result of your test is
known. This is to prevent the infection from spreading to other patients.
What treatments are available?
If the test for CPE is negative, it means that you are not colonised or infected with
any CPE and no treatment or extra care precautions are necessary. If you are in a
single room, you may be moved back to the main ward area.
If you test positive for any CPE it means that you have the bacteria in your body.
You may not show any symptoms (colonisation) or you may feel unwell and
experience symptoms (infection). If your doctor thinks you are showing signs of
infection he or she will prescribe a course of antibiotics.
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While you are in hospital the following will apply:
you will be cared for in a single room with your own toilet facilities
staff caring for you will wear personal protective equipment such as gloves
and aprons to prevent spreading the bacteria to other patients
it is very important that you wash your hands thoroughly with soap and water
after visiting the toilet and before eating (staff will help you if you need them
it is very important that all healthcare staff and your visitors wash their hands
with soap and water before entering and leaving your room
you should avoid touching medical devices such as intravenous drips or
catheters (if you have any)
you should avoid touching open wounds (if you have any).
What are the risks or side effects of CPE?
CPE can sometimes live in the gut of humans, so it can be difficult to say exactly
how and where you got them. We do know that you are at an increased risk of
getting CPE if you have been in a hospital abroad, or in a UK hospital which has
had any patients colonised or infected with these bacteria.
CPE are not a problem for fit and healthy people, so family and friends are still
encouraged to visit you. The general advice for hospital visitors is as follows:
relatives, friends and other people who are feeling unwell should not visit you
visitors who have had a recent infection or illness should ask the nursing staff
on the ward for advice before visiting
children and babies can be more vulnerable to infection. Please discuss with
the Infection Control Team as to whether visiting is advisable
follow the instructions on the room door or from nursing staff before entering
the room
visitors and relatives can still touch you (for example, hold your hands or give
you a hug)
visitors must wash their hands well with soap and water before entering and
leaving your room to help prevent these bacteria from spreading to other
What happens after treatment?
if you are discharged from hospital with CPE it should not affect you or your
family home
staff from the hospital will tell your GP about your CPE condition when you
are discharged from hospital
hand washing is very important to prevent these bacteria spreading. So you
must wash your hands well with soap and water after going to the toilet and
before eating. Anyone looking after you must also regularly wash their hands
well to prevent spreading CPE to other people
staff caring for you in hospital may wear gloves and aprons when carrying out
certain tasks. This is to prevent spreading CPE to other patients they are
caring for. When you leave hospital, it is not necessary for your family
members to wear aprons and gloves
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June 2018
if you have any invasive medical devices, for example a urinary catheter, you
should only touch these if instructed to clean them
you should make sure your toilets and bathrooms are regularly cleaned with
your usual household cleaning products
you can continue with leisure and social activities as normal
you should encourage visitors and relatives to wash their hands with soap
and water
crockery, cutlery and so on can be washed as normal
you can wash clothes and bed linen as normal at the hottest temperature
suitable for the fabric. If laundry is soiled, it should be washed separately at
60oC. If friends or relatives are helping you with your laundry it is important
that they wash their hands with soap and water after handling the dirty
What if I need to go back into hospital or go to hospital as an outpatient?
If you are admitted back into hospital or go to hospital as an outpatient, it is
important that you let the staff caring for you know that you have had a positive test
for CPE in the past 12 months. This will make sure that you are tested again and
receive the best care to reduce the risk of you developing a CPE infection. It might
be helpful to take this leaflet with you to show the clinical team.
Useful information
If you would like more information please speak to a member of the nursing or
medical team caring for you, who may contact the Infection Control team for you.
Based on the leaflet produced by a working party led by Health Protection Scotland on behalf of the
joint societies- British Infection Association (BIA), British Society for Antimicrobial Chemotherapy
(BSAC), Infection Prevention Society (IPS) and Healthcare Infection Society (HIS). Journal of
Hospital Infection (2016) 92
Verifying your identity
When you attend hospital you will be asked to confirm your first and last name, date
of birth, postcode and NHS number if you know it, and to let us know if you have
any allergies.
Comments, compliments or complaints about your care?
Please call PALS (Patient Advice Liaison Service) on 01206 742683, pick up a
leaflet or visit
Infection Control Department
Villa 2
Colchester General Hospital
Turner Road
Tel: 01206 744268
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Leaflet name
Leaflet number
Next review
June 2016
June 2018