Infection Prevention & Control
Information for parents and carers
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CPE (Carbapenemase producing Enterobacteriaceae)- PIAG 123 (94kB pdf)
Introduction
This leaflet provides parents and carers with information about CPE (Carbapenemase producing Enterobacteriaceae)
What are CPE?
Enterobacteriaceae are bacteria that usually live harmlessly in the gut of humans. This is called ‘colonisation’ and the person is said to be a ‘carrier’. However, if these bacteria get into the wrong place, such as the bladder or bloodstream they can cause infection. Carbapenems are one of the most powerful antibiotics available. Carbapenemases are enzymes (chemicals), which can destroy carbapenem antibiotics making the bacteria resistant and infections difficult to treat.
What are the signs and symptoms of CPE carriage?
Carriers of CPE will have no signs and symptoms and require no treatment. They have a resistant strain of a normal bowel bug in their bowel. It is not causing them harm. It is only if this bowel bug gets into another site, for instance their blood stream or a wound site that it can cause an infection requiring treatment. Because it is resistant to one of the strongest antibiotics available, infections caused by CPE can be difficult to treat.
How is CPE carriage identified?
At Alder Hey we carry out “surveillance”, actively looking for carriage of resistant
organisms. Because it is a bowel bug, we will ask for a faecal (stool) sample and / or a
rectal swab ie. a sample taken by inserting a swab briefly just inside the rectum (bottom).
Results of these swabs are usually available within two to three days.
How do people become carriers of CPE?
How do people become carriers of CPE? It can be difficult to say how people pick up CPE. Risk factors for CPE carriage include, having been an inpatient in a hospital abroad or in the UK where CPE patients were present, or if you have been in contact with a carrier elsewhere.
What treatment(s) are available?
Remember, carriage of CPE will not require treatment. However, carriers of CPE will be nursed in isolation with additional precautions to ensure the CPE does not move from their bowel to any other site on them, and does not spread to other patients present on the ward. There are limited antibiotics available to treat infections caused by CPE
What can patients with CPE do for themselves?
The most important thing carriers of CPE can do is to wash their hands well with soap
and water, especially after going to the toilet. Carriers should avoid touching any medical
devices they may have, such as urinary catheters and intravenous drips, particularly at the point where it is inserted into the body or skin. Visitors will be asked to wash their hands on entering and leaving the room and wear an apron for delivering personal care.
What happens when I go home?
CPE carriage will not delay your discharge home. You can carry on as normal, and practice good hand hygiene. Before you leave hospital, ask the doctor or nurse to give you a letter stating that you are a carrier of CPE. If you, or a household member, need to attend hospital in the future, you can let health care staff know about your carriage / contact with CPE. Although CPE carriage can go away with time it is not guaranteed, therefore if you return to Alder Hey for further treatment you will always be nursed in a single room with the same additional precautions.
This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.
This information can be made available in other languages and formats if requested.
Alder Hey Children’s NHS Foundation Trust
PIAG: 123