Carbapenemase Producing Enterobacteriaceae (CPE)

Executive Summary

This policy sets the Trust standards for infection prevention and control when assessing and caring for patients with carbapenemase-producing Enterobacterales (CPE) / Carbapenem Resistant Organisms (CRO).

Enterobacterales are a large family of bacteria that live harmlessly in the gut of humans and animals. They include species such as Escherichia coli, Klebsiella species and Enterobacter species and often cause a variety of infections, including urinary tract infections, intra-abdominal and bloodstream infections.

Carbapenems are a valuable family of penicillin-like antibiotics normally reserved for treating serious life-threatening infections in hospital, caused by multidrug resistant Gram-negative bacteria. They include meropenem, ertapenem, imipenem and doripenem. Some enterobacterales are resistant to antibiotic treatment by producing enzymes called carbapenemases, which destroy carbapenem antibiotics. Enterobacterales that produce carbapenemases are referred to as CPE / CRO. (KPC, OXA-48-like, NDM, VIM, and IMP enzymes are the most prevalent enzymes in the UK.)

These resistant bacteria can spread rapidly in healthcare settings and serious infections caused by CPE / CRO can affect patient morbidity and mortality. It is therefore very important to identify patients with CPE / CRO as early as possible and use the correct infection prevention and control precautions, including early isolation, to minimise the risk of cross-infection.

This policy details how to assess and screen patients for CPE / CRO, as well as the required infection prevention and control precautions.

The standards detailed in the policy are applicable to all staff who work in wards or other clinical departments, including support staff who assist with patient care in any way.

Policy Details

See also:

• Standard Infection Prevention and Control Precautions Policy