Information for patients who have been in contact with someone who has Carbapenemase-producing Enterobacteriaceae (CPE)

You or your relative, have been found to be in contact with a patient who was colonised and / or infected with a carbapenemase-producing Enterobacteriaceae (CPE). This leaflet explains how we test for and treat bacteria (germs) called carbapenemase-producing Enterobacteriaceae (CPE).

If you have any questions or concerns, please speak to the doctors or nurses caring for you.

What are Carbapenemase-producing Enterobacteriaceae?

There are many different types of bacteria that live harmlessly in the human gut; this is called colonisation. Colonisation is when a person is said to be a carrier. However, if this bacteria gets into the wrong place, such as the bladder or bloodstream, they can cause infection.

Carbapenemases are enzymes (chemicals) made by some strains of these bacteria, which allow them to destroy carbapenem antibiotics, a powerful group of antibiotics. The bacteria are then 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 treat certain ‘difficult’ infections, when other antibiotics have failed.

In hospital, where there are many vulnerable patients, the spread of resistant bacteria can cause problems.

There is an increased chance of picking up these bacteria if you have been:

• a patient in a hospital abroad

• in a UK hospital that has had patients carrying the bacteria, or

• in contact with a carrier elsewhere.

Who is most at risk of getting a CPE infection?

People whose ability to fight infections is low, are more likely to get a CPE infection. This can include people:

• with cancer

• having dialysis and those with indwelling lines

• being treated in the Critical Care Unit, including those with a tracheostomy tube

• who have had transplants

• with chronic (long-term) wounds

• with enterotomies (a surgical cut in the intestine).

Do I need to be screened for CPE?

Occasionally. It is not immediately known that a patient is carrying these bacteria, so they may not be placed into a single room straight away.

Screening will be offered because you have shared the same bay with a patient who has been found to be carrying CPE. There is a potential risk that you could have picked up the bacteria and are carrying it too.

• If you have been identified as a contact whilst you are inpatient, screening will be offered during your inpatient stay.

• If you have been identified as a contact after you have been discharged home, there are no specific actions you need to take.

  If you are admitted to any hospital over the next 12 months, it is important that you tell the healthcare professionals looking after you that you may have been in contact with CPE. An alert will also be placed on your health record. This will allow the healthcare provider to ask for routine screening, to check if you are colonised with the organism.

How is the infection found?

Samples (swabs) may be taken from one of the following places.

• A rectal swab, taken by inserting a swab briefly just inside your rectum (bottom).

• A stool (poo) sample.

You will be asked for your consent before we take a rectal swab.

What happens when my results comes back?

• If your result is negative, no further tests are needed.

• If your result is positive, your doctor or nurse will discuss this with you.

  • You will be cared for in a single room while you are in hospital.

  • If you have an infection, you will need antibiotics. However, if there are no signs of infection and you are simply carrying the bacteria, no treatment will be needed. For more information, please see the Carbapenemase-producing organism (CPO) / Carbapenemase-producing Enterobacteriaceae (CPE) leaflet.

Where can I find more information?

If you have any questions or concerns, please speak to either the nurse in charge of the ward, the matron, or your GP. If they cannot help you or you need further information, please contact a member of the Infection Prevention and Control Team.

• Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 766877 extension 722-4216 or 722-6810

• Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 225544 extension 725-4234 or 725-3625

• William Harvey Hospital, Ashford
  Telephone: 01233 633331 extension 723-8198 or 723-8202

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• Patient Voice Team
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