What is meant by ‘carbapenemase-producing Enterobacteriaceae’?
Enterobacteriaceae are bacteria that usually live harmlessly in the gut of humans. This is called ‘colonisation’ (a person is said to be a ‘carrier’). 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. Carbapenemases are enzymes (chemicals), made by some strains of these bacteria, which allow them to destroy carbapenem antibiotics and so the bacteria are said to be resistant to the antibiotics.
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 ‘difficult’ infections when other antibiotics have failed to do so. Therefore, in a hospital, where there are many vulnerable patients, spread of resistant bacteria can cause problems.
Does carriage of carbapenemase-producing Enterobacteriaceae need to be treated?
If a person is a carrier of carbapenemase-producing Enterobacteriaceae (sometimes called CPE), they do not need to be treated. As mentioned above, these bacteria can live harmlessly in the gut. However, if the bacteria have caused an infection then antibiotics will be required.
How is carbapenemase-producing Enterobacteriaceae spread?
If a patient in hospital is carrying this bacteria it can get into the ward environment and can also be passed on by direct contact with that particular patient. For that reason, the patient will normally be accommodated in a single room. Effective environmental cleaning and good hand hygiene by all – staff and patients – can reduce the risk of spread significantly.
Do I need to be screened?
Occasionally, it isn’t immediately known that a patient is carrying this bacteria and so they may not be placed into a single room straight away. Screening will be offered if you have shared the same bay (or ward) with a patient who has been found to be carrying carbapenemase-producing Enterobacteriaceae. This screening is offered as there is a slight chance that you could have picked up the bacteria and are carrying it too.
How will I be screened for carbapenemase-producing Enterobacteriaceae?
Screening usually entails taking a rectal swab by inserting it just inside your rectum (bottom). Alternatively, you may be asked to provide a sample of faeces. The swab / sample will be sent to the laboratory and you will normally be informed of the result within two to three days. If the result is negative nothing further is required unless you are staying in hospital for some time. In that case, you will probably be asked to provide a sample on a regular basis eg once a week, as a precautionary measure.
What if the result is positive?
If the result is positive do ask your doctor or nurse to explain this to you in more detail and to provide a copy of the leaflet relating to positive results (Carbapenemase-producing Enterobacteriaceae: Carriers & Carriage) available on the Infection Control web site at this Trust. You will be given a single room until you leave hospital. No treatment is necessary unless you have an infection when antibiotics will be given.
What if I need more information?
More information is available from your doctor or nurse. Other people that can answer your questions include the Consultant in Communicable Disease Control at the UK Health Security Agency (Yorkshire & Humber) and members of the Infection Prevention & Control Team at the hospital.
Any comments, compliments, concerns or complaints
If you have any other concerns please talk to your nurse, therapist or doctor. Our Patient Advice and Liaison Service (PALS) is available on 03033 306518 (Grimsby, Scunthorpe and Goole). You can also contact [email protected].
NHS website
NHS website is a health information service. The aim is to support the public to become active consumers of healthcare rather than passive recipients, and to help individuals, their family or carers to make more informed choices: https://www.nhs.uk/
Review information
Date of issue: May 2014
Review period: March 2026