Skip to main content
Normal text size icon Increase text size by 30% icon
NGH Long NHS75 logo

Carbapenemase Producing Enterobacterales (CPE) and Antibiotics

This patient guide answers some commonly asked questions about antibiotics and CPE.

What is CPE?

CPE stands for Carbapenemase Producing Enterobacterales. Enterobacterales are a family of bugs (bacteria) normally found in the gut. Sometimes these bugs spread to other areas of the body and can cause serious infections, such as wound infections, urinary infections and blood stream infections. Carbapenems are a powerful group of antibiotics. CPE produce enzymes (chemicals) that can break down this type of antibiotic making the bugs resistant.

Can CPE be harmful?

For most patients CPE live harmlessly in our gut and do not cause infection; this is known as colonisation. The person’s immune system keeps the CPE in check within the gut and prevents it from spreading to other areas of the body. Colonisation can lead to an infection if the patient’s immune system is not working properly or if the bugs spread to other parts of the body. The bugs can enter the body through medical devices like intravenous catheters and urinary catheters and wounds.

CPE are resistant to many antibiotics making infection with these bugs very hard to treat.

How do people get CPE?

CPE is currently a major risk if you have received care (including renal dialysis) from a healthcare setting either in the UK or abroad in the last 12 months or you live with someone known to have CPE.

How is CPE spread?

CPE can be spread between patients by direct contact with each other or by touching surfaces or items that the person with CPE has touched. 

CPE can be spread from one person to another by unwashed hands or from contact with dirty equipment or surfaces. This can lead to harmless carriage of the bugs or an infection if CPE enters the body at specific sites and causes signs and symptoms of infection.

CPE cannot be spread through the air, but can survive on equipment and surfaces, such as toilets, commodes, bedrails, tables, chairs and door handles.

Effective environmental cleaning and good hand hygiene by all patients, staff, visitors and relatives can reduce the risk of this bug spreading.

Visitors and relatives who participate in patient care e.g. helping with patient washes should wear aprons and gloves. It is important that gloves and aprons are removed and hands are washed prior to leaving the room.

How do you know if you are carrying CPE?

A swab will be taken from the back passage or a faecal (stool) specimen is obtained, as CPE are usually carried in the bowel. If you have wounds or medical devices such as a PEG, catheter, cannula or central line then a swab will be obtained from each of these sites. These swabs will be sent to the laboratory for testing.

A result will normally take 72 hours to be available and the clinical team treating you will inform you directly of the results. If the results are positive then the isolation and standard infection prevention precautions started on admission should be maintained for your hospital stay.

Please note if you have been positive in the past followed by a negative result isolation precautions will be continued as a negative result can revert to a positive result especially following a further course of antibiotics.

What Special Precautions Are Required?

Early detection of the CPE bug is vital to help prevent further spread within United Kingdom hospitals. Following the recommendations from UK Health Security Agency (UKHSA) all patients that have had renal dialysis or have been treated in a hospital aboard or in the UK within the last twelve months or if you or your close contacts (person sharing same sleeping space) has been previously colonised or infected with CPE should be isolated immediately on admission to hospital and screened for CPE.

To prevent possible spread to other patients in hospital, standard infection prevention precautions are required for patients colonised or potentially colonised with CPE. These patients will be nursed in a single room with their own toilet or commode. A sign will placed on the door to remind people who enter the room about the special precautions i.e. instructions to clean hand prior to entering, and for staff to wear aprons and gloves. Everyone who leaves the room must remove their gloves and aprons and clean their hands. Hand washing is the single most important action that can be taken to help prevent the spread of infection.

Healthy family members and visitors have a low risk of acquiring CPE. All visitors must clean their hands before and after entering your room. They should not use your toilet facilities or eat and drink in your room.

What happens when I go home?

There is no need for special precautions when you go home. You should carry on as normal, maintaining good hand hygiene. If you are found to be colonised with CPE and any of your close contacts are admitted to a healthcare facility, you should inform them that you have CPE.

This fact sheet provides basic general information. If you have any further questions please ask your nurse to contact the Infection Prevention Team and one of the nurses will come and speak to you.

For further information please contact the Patient Advice and Liaison Service who can signpost you appropriately.

Back to Top