Patient information: Carbapenemase-producing Enterobacteriaceae (CPE)
What is CPE?
Carbapenemase-producing Enterobacteriaceae (sometimes called CPE) is the name given to a group of bacteria that have become very resistant to antibiotics including those called carbapenems. Enterobacteriaceae are a large family of bacteria that usually live harmlessly in the gut of all humans and animals without causing problems (‘colonisation’). However, if they get into the wrong place such as the bladder or bloodstream they can cause infection. You may be a carrier of CPE (colonised), this means that the bacteria are present in your body but are not causing illness or infection and treatment is not generally required.
Why does carbapenem resistance matter?
Carbapenems are a valuable family of antibiotics normally reserved for serious infections. Until now, they have been the antibiotics that doctors could always rely upon when other antibiotics failed. However, infections caused by CPE can be difficult to treat with antibiotics therefore steps need to be taken to prevent the infection spreading to other people.
How did I get CPE?
There are many ways that you may have come into contact with this germ. You are more likely to develop CPE if you have been in a hospital including those abroad or being exposed to other carriers of this germ.
How can the spread of CPE be prevented?
Carrying CPE will not affect family or friends provided that everyone has good hand washing
practices. Hands should always be washed with soap and water:
- before preparing or eating food
- after using the toilet
- after touching any wounds or medical devices that you may have
No special cleaning is required in the home and your clothes may be washed in the usual manner,
along with the rest of the household laundry. If you live in a care home the staff looking after you
may need to take additional precautions to prevent the spread of CPE. If you have concerns you
should speak to the staff looking after you
Can I be cured of CPE?
Sometimes the body will eventually clear itself of CPE by its natural healing and cleansing action. There are some medicines available to help to treat CPE infection but there is no medicine to help remove CPE colonisation.
Who should I tell if I have CPE?
If you need care from your doctor, nurse, a hospital or other healthcare worker, please tell them that you have tested positive for CPE.
Further information
If you would like further information please contact the Infection Prevention and Control Service on 0151 604 7750.
Download the PDF leaflet:
Information for healthcare workers:
What is Carbapenemase Producing Enterobacteriaceae?
CPE is the name given to a group of bacteria that have become resistant to antibiotics, including those called carbapenems. CPE infections are much more difficult to manage as there are limited treatment options.
What are Enterobacteriaceae?
Enterobacteriaceae are a family of bacteria that occur naturally in the gastro-intestinal tract (bowel). These bacteria can spread outside the gastro-intestinal tract and cause serious infections such as bacteraemia (bacteria in the blood), pneumonia, urinary tract and wound infections.
What are Carbapenems?
Carbapenems are a powerful group of broad spectrum antibiotics (imipenem, meropenem, doripenem, ertapenem) which in many cases are the last effective defence against multi-resistant bacterial infections.
Who is at risk?
Infections caused by CPE most commonly occur in people who have:
- chronic medical conditions
- recent or prolonged stays in healthcare settings (including hospitals outside of the UK)
- invasive medical devices such as ventilators or intravenous catheters
- history of taking certain antibiotics for long periods of time
- healthy people do not usually get infections caused by CPE
About CPE
- the majority of people who acquire CPE are colonised rather than infected
- colonisation is when there is bacteria present on or in the body but those bacteria are not causing any harm, there is a risk that these bacteria can be transferred from one person to another as a result of cross infection
- the primary site of colonisation is the lower gastro-intestinal tract
- the duration of colonisation is unknown but can be very long-term, therefore it is not always
- necessary to isolate residents in Care Homes who are known to be colonised with antibiotic resistant bacteria
- CPE is not a reason for a person to be refused health or social care
- good hand hygiene and the use of standard precautions will help minimise the spread of these organisms
Does colonisation with CPE need to be treated?
CPE may live in the gut without causing problems (referred to as colonisation) and does not always need treatment. However, if they cause an infection then treatment is required. There is insufficient evidence to suggest that routine treatment for colonisation would be effective therefore treatment is not routinely recommended.
How can CPE be eradicated from the body?
There is no treatment to eradicate CPE, sometimes the body will clear these organisms as part of its natural process but if this does not happen they are unlikely to cause the patient any harm unless they cause infection. Infection control standard precautions must be routinely applied to reduce the potential risk of cross infection.
Transmission
CPE can be passed from one person to another on the hands of health and care staff or through contact with contaminated surfaces or equipment.
How can the spread of CPE be prevented?
- hand hygiene in accordance with the WHO’s ‘5 moments for hand hygiene’
- patients/residents should be encouraged to wash their hands particularly after going to the toilet
- appropriate use of Personal Protective Equipment (PPE)
- enhanced environmental cleaning and disinfecting in care homes focusing on surfaces in close proximity to resident and frequent touch points
- people receiving care in their own homes do not need to take any additional precautions
- single use medical devices/equipment where appropriate
- dedicated equipment where feasible and thorough cleaning of all reusable medical devices
- prudent use of antibiotics
If you require further information please contact the Infection Prevention and Control Service on 0151 604 7750.
Download the PDF leaflet:
