Leaflet Details
| Title | Carbapenemase-Producing Enterobacterales (CPE) |
| Department | Infection Control |
| Author(s) | Shila Patel |
| Review Date | April 2025 |
| Next Review | July 2027 |
| Download | A4 Handout PDF |
| Accessibility Options | Click on the Recite Me button to show our accessibility resources |
Patient Information
What is CPE?
Carbapenemase-producing enterobacterales (CPE) are a large family of bacteria (germs) that usually live harmlessly in your gut (bowels). This is called colonisation. Someone who is colonised is called a carrier, because they are carrying the bacteria (germs) without causing them any ill-health and this means you will be unaware that you are a carrier. No treatment is needed when you are carrying the germs harmlessly.
CPE bacteria (germs) are highly antibiotic resistant, which means if someone does develop an infection from these germs, treating the infection is much harder.
When can CPE become harmful?
Whilst the bacteria (germs) remain in your gut harmlessly, they do not pose a problem.
Sometimes the bacteria (germs) can cause a problem for people who find it difficult to fight infection, such as those with weakened immune systems caused by cancer or other illnesses, or acutely unwell patients in hospital with medical devices, such as urinary catheters and intravenous devices, or large open wounds. If the bacteria (germs) enter areas of the body where they do not normally live, such as the bladder or the bloodstream, they can cause infections, such as urinary tract infections and bloodstream infections. Treating these infections is much more challenging, as CPE is highly antibiotic resistant.
CPE is not a risk to healthy people, including visitors and staff. However, they may spread the bacteria (germs) from one person to another. This is why infection prevention and control precautions are very important and should be followed by everybody.
How is CPE spread in hospital?
The bacteria (germs) can be spread in a number of ways:
- from person to person, on the hands and skin of anyone including staff, students, patients and visitors, by touching someone who is infected or colonised (carrying the bacteria / germs harmlessly)
- by touching contaminated surfaces or objects in the environment, such as patient equipment / medical devices, bedside tables or lockers, computer keyboards, telephones, commodes and toilets that have CPE on them. Essentially, any surface can become contaminated.
It is important to note that CPE is not a respiratory infection and is not spread through coughing or sneezing.
How do we prevent spread from one person to another?
Staff are trained to use standard infection prevention and control precautions when caring for all patients, this includes:
- good hand hygiene (staff will not be offended if you ask them if they have cleaned their hands at appropriate times)
- being bare below the elbows on entry to all clinical areas, to allow for good hand hygiene
- using personal protective clothing, such as disposable gloves and plastic aprons, when needed, for example when dealing with blood / body fluids or open wounds
- cleaning patient equipment thoroughly after each use
- disposing of used laundry and waste correctly
- good environmental cleaning.
We also encourage:
- all patients to clean their hands after using the toilet and before meals
- all visitors to clean their hands when visiting and before leaving our wards. If you are visiting a patient in a single room, please wash your hands with soap and water before leaving the room.
In addition, when we know that a patient has CPE, we will care for the patient in a single room to further reduce the risk of spreading the bacteria (germs).
How do we check for CPE?
One of the main ways that CPE is spread is by being admitted into hospital (where you may have contact with someone with CPE). For this reason, when you are admitted to our hospitals we will ask you:
In the last 12 months:
- Have you previously been told that you have CPE or had contact with someone with CPE
- Have you been an inpatient in any hospital, in the UK or abroad
- Have you had regular hospital treatments, for example dialysis.
If any of these apply, we will then screen (test) you for CPE.
We will also screen you if you are admitted to a high-risk unit, such as Intensive Care. Whilst we are waiting for the screening results, we will move you into a single room (if you are not already in a single room), in case the test is positive, to prevent spread to other patients.
How do we screen (test) for CPE?
We usually take samples from your rectum (the end part of your gut / your bottom), where a swab (very similar to a long cotton bud) is briefly put just inside your bottom (3 to 4cm into your bottom). We may also test samples of your faeces (poo) and other relevant sites (such as open wounds, if you have any). The samples are then tested in a laboratory to look for CPE.
The results take approximately 3 days to come back. Your doctor or nurse can let you know the test results. Please ask them for the results as you need to.
What happens if I have CPE (the test is positive)?
We will care for you in a single room throughout your hospital admission (including any future admissions), to prevent spread to others. If you are only colonised (carrying the bacteria / germs harmlessly, without causing you ill health), you won’t need any treatment.
If you do develop an infection, we will give you antibiotics for treatment, following specialist microbiology advice.
How did I get CPE?
It can be difficult to say when or where you picked up the CPE bacteria (germs), as many people with CPE are totally unaware that they are colonised (carrying the bacteria / germs harmlessly).
There is a greater chance of picking them up if you have been admitted into hospital in the UK or abroad, as other people with CPE can also be receiving care at the same time, or if you have been in contact with someone who has CPE elsewhere.
What happens when I go home?
You may still be a carrier when you go home. However, as CPE is not a risk to healthy people, you do not need to take any special precautions and if you did have a CPE infection, we will have treated the infection before discharging you from hospital.
Once home, you can carry on as normal. You don’t need to isolate yourself from your family or friends, including children. Continue to maintain good hand hygiene as you would normally.
If you have any concerns, contact your GP for advice. When you are discharged from hospital, your GP will be informed that you have CPE.
Do I need to tell anyone I have CPE?
If you are readmitted into hospital for any reason, or you receive healthcare in the community, please inform the staff caring for you that you have CPE. Staff caring for you will use precautions to prevent spread to other vulnerable patients who may develop CPE infection, this includes caring for you in a single room if you are readmitted into hospital.
How long will I have CPE (colonisation)?
It is hard to say exactly how long you will carry the bacteria / germs harmlessly (be colonised). Some people are colonised for prolonged periods of time (without the bacteria / germs causing them any harm, similarly to many other germs people have on their bodies) and for this reason we will care for you in a single room throughout your hospital admission and all future admissions.
Who can I contact if I have further questions?
If you have any other questions or concerns, please do talk to the doctors or nurses caring for you. If they are unsure about any of your queries, they can seek further advice from the Microbiology Department or the Department for Infection Prevention and Control and if needed, can arrange a meeting with a specialist nurse or doctor to provide further information for you.
You can also access information on the internet:
Framework of actions to contain carbapenemase-producing Enterobacterales
https://assets.publishing.service.gov.uk/
