Carbapenemase Producing Enterobacteriaceae (CPE)

What are ‘CPE’?

Carbapenemase Producing Enterobacteriaceae (CPE) are bugs which can live in the gut of humans and animals. At times CPE are harmless and there are no signs or symptoms because a person’s immune system keeps them in check. This is called ‘colonisation’. If they get into other parts of the body eg the urine or the blood, they can cause an infection and will need treatment. This can happen in patients who have a weakened immune system.

CPE infections can be tough to treat because they are resistant to lots of antibiotics, including ‘Carbapenems’ which are only used in severe cases. CPE can also pass their resistance on to other bacteria, making them harder to treat as well.

If you are admitted to hospital and you have a CPE infection or colonisation you will be cared for in a side room. We hope that this will stop the spread of CPE and will reduce the risks to all patients.

How do people get CPE?

People can get CPE if they have been in hospitals abroad (such as in India, Israel and Greece) but also if they have been in certain hospitals in the UK. You must let your doctor know if you have been in a hospital in a different country or the UK so that they can care for you properly.

You can also become colonised with CPE if you have received lots of antibiotics in the past. This is because the resistant bugs that survive after you have taken antibiotics can then grow.

CPE are often passed from person to person after touching bed rails, toilets or devices. This means that is important to regularly wash your hands with soap and water.

Why am I being tested?

You will be tested for CPE if:

• You have been a patient in a hospital in a foreign country
• You have been a patient in a hospital in the UK which has had a spread of the infection
• You have had CPE in the past
• A person you are in close contact with has CPE.

How will I be tested?

The best way to see if you have CPE is to take a quick swab from your rectum (back passage) or to collect a stool sample (a sample of your poo). This is where the bugs will be.

The sample will be sent to the test centre and the results will be sent to your doctor on the hospital ward. While you are waiting for the results you may be kept in a side room as a safety measure.

What if I test negative?

This means that you are not infected or colonised with CPE and you may be moved back to the ward area. You could be tested for CPE again if you are in hospital at another time.

What if I test positive?

If you test positive for CPE it means that you have these bugs in your body, but it does not always mean that you are infected. If your doctor thinks you show signs of infection, they will contact the microbiology doctors. They will suggest some antibiotics that are suitable to treat the infection.

You will stay in a side room with your own toilet facilities while you are in hospital. The staff will wear aprons and gloves when they are caring for you. They will wash their hands when they leave, which is standard practice at Dorset County Hospital.

Can I still have visitors?

CPE is not a problem for healthy people and you are still encouraged to have family and friends come to visit. We ask that they wash their hands before they leave your room and do not mix with other patients on the ward. This makes it easier for us to prevent the spread of the bugs.

What happens when I leave hospital?

CPE may stay in your system for a long time. At present there is no way of knowing if patients have become decolonised (meaning CPE has resolved/gone) therefore if you are ever in hospital again in the future, it is vital that you stay in a side room in case it is still present in your system. You should let the doctors know that you have a known history of CPE (or show them this leaflet).

You can go home if your doctor thinks it is suitable. We advise that you let your GP know that CPE was identified while you were in Dorset County Hospital.

Contact numbers

We hope that you have found this information useful. If you have any questions or are worried about anything, please speak to the following Dorset County Hospital staff:

Infection Prevention Management team: 01305 253279

About this leaflet

Author: Emma Hoyle, Associate Director Infection Prevention and Control
Written: February 2017
Updated and approved: February 2023
Review date: February 2026
Edition: v2

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk