Carbapenemase Producing Enterobacteriaceae (CPE)

Patient Information Leaflet

What is CPE?

• CPE stands for Carbapenemase-producing Enterobacteriaceae.
• These are bacteria, usually Escherichia coli (E. coli) or Klebsiella that live in the bowel (intestines) and become resistant to antibiotics.
• For most people who have these bacteria living in them, this causes no harm (this is called colonisation).
• Unfortunately, if they cause infection, this can be serious, as there are few antibiotics to treat it.

How do people catch CPE?

• It can be impossible to know exactly how an individual has developed CPE colonisation but there are risk factors for being colonised.
• CPE has been seen in hospitals outside the UK and in the UK as well as in London.
• In some hospitals there has been cross infection from one patient to another.
• To reduce the risk of cross infection, 'suspected carriers' are screened (tested) to determine if they do have the bacteria.

Who is a 'suspected carrier'?

• If you are being admitted to hospital, we will ask you two questions to find out if you are at risk of being a suspected carrier.
  1. Have you been an in-patient in a hospital outside the UK or in a UK city within the last 12 months?
  2. Have you been told you have a resistant strain of E. coli or Klebsiella?
• If the answer to either of these questions is 'yes' we will then test you.
• If a patient is found to be CPE positive within the hospital, we may also test nearby patients to ensure that there has been no spread.

How do we test for CPE?

• As CPE colonises the bowels, we need to take a swab (sample) from your rectum (bottom) to test to ensure you are not colonised.
• This is then sent to the laboratory. It takes around two working days for a result.
• While waiting for the result, we may isolate you to reduce the risk of cross infection to others.

What if the swab is negative?

• If the swab is negative, you are not currently carrying CPE. But we may need to take another swab depending on risk of carrying CPE.
• If you are re-admitted, you will be asked the questions again and will need to be tested again.

What if any of the swabs are positive?

• If any of the swabs come back as positive, then you are considered CPE positive.
• If you are not currently in isolation, you will be isolated.
• Visitors will be asked to wash their hands thoroughly when leaving your room.
• As CPE is very resistant, you may not be treated unless you have an infection.
• Even if treated, there is a possibility that not all of the bacteria will be killed.
• Further testing following treatment could show negative, but it may turn positive again in the future.
• Therefore, we have to assume that if you are positive once, you are positive always.
• A diagnosis of CPE colonisation should not delay your discharge.

What do I do at home if I have CPE?

• There are no special measures that you will need to take at home.
• As the bacteria is found in the bowel, please make sure that you always wash your hands after using the toilet.
• People living in the same household can pass bacteria to each other.
• Therefore, if you are admitted to hospital in the future, please inform staff that you or a member of your household have CPE.

Any further questions?

• If you have any further questions, please contact the Infection Control Team, on 020 7288 3679, or you can ask the ward manager to contact us.
• Additional information can be found on NHS Choices:
  https://www.nhs.uk/
  https://www.nhs.uk/conditions/antibiotics/antibiotic-antimicrobial-resistance/