What are carbapenemase-producing organisms?
There are many micro-organisms / bacteria that live harmlessly in the gut of humans. However, these bacteria can cause infection if they enter or are transferred to other parts of the body, e.g. blood and urine.
Carbapenems are one of the most powerful types of antibiotics. Carbapenemases are enzymes (chemicals), made by some strains of bacteria, which allow them to destroy the carbapenem antibiotics and so the bacteria are said to be resistant to the antibiotics.
What illnesses do carbapenemase-producing organisms cause?
E.coli, Enterobacter and Klebsiella, although common bacteria that live in the gut, can cause infection in humans. Infections tend to be in the urinary tract and blood. When infection is caused by carbapenemase-producing bacteria it is more difficult to treat because of antibiotic resistance.
How are carbapenemase-producing organisms spread?
These bacteria can be spread in the following ways:
- Directly - from person to person on the hands, or by direct contact with a patient who is a carrier of this bacteria.
- Indirectly - from ward environment (if a patient in hospital is carrying this bacteria it can get into the ward environment), or from contaminated equipment which has not been cleaned properly.
How will I know if I am at risk of being a carrier or having an infection?
Your doctor or nurse may suspect that you are a carrier if you have been in a hospital abroad, or in a UK hospital that has had patients carrying these bacteria. If any of these reasons apply to you, screening will be arranged for you and you will be nursed in a single room with your own toilet facilities at least until the results are known.
How will I be screened for carbapenemase-producing organisms?
Screening usually entails taking a rectal swab or you may be asked to provide a sample of faeces. The result should be available in two to three days. Three negative samples are required before you can be moved out of the single room.
What happens if my result is positive?
If the result is positive, do ask your doctor or nurse to explain this to you in more detail. You will continue to be nursed in a single room. If you have an infection, you will need to have antibiotics. However, if there are no signs of infection and you are simply ‘carrying’ the bacteria, no treatment is required.
Can carbapenemase-producing organism infections be treated?
Yes, there are still antibiotics that will treat infection effectively. Your doctor will need to discuss treatment with the Consultant Microbiologist and / or Antibiotic Pharmacist.
How long do patients with carbapenemase-producing organisms have to stay in a single room?
Isolation in a single room will need to be continued while you are in hospital.
What about my visitors?
Visitors will be asked to wash their hands on entering and leaving the room. For social visiting gloves and aprons are not required.
When can I go home?
You will be discharged home when your clinical condition allows. Whilst there is a chance that you may still be a carrier when you go home, quite often this will go away with time. No special measures or treatment are required; any infection will have been treated prior to your discharge. You should carry on as normal, maintaining good hand hygiene. If you have any concerns you may wish to contact your GP for advice.
Before you leave hospital, ask the doctor or nurse to give you a card advising that you have had an infection or been colonised with carbapenemase-producing organisms. This will be useful for the future and it is important that you make health care staff aware of it.
Should you be admitted to hospital, you should let the hospital staff know that you are, or have been, a carrier and show them the card.
How should clothes be washed?
Clothes should be washed in a washing machine at the highest possible hot wash the fabric can withstand (refer to laundry label on garment). Laundry should be placed directly into the drum of the washing machine. Wash your hands after handling laundry.
What is Ashford and St Peter’s Hospitals Trust (ASPH) doing about carbapenemase-producing organisms?
Infection prevention and control remains a priority and is taken very seriously at ASPH. There are guidelines and procedures in place to minimise the risks of acquiring an infection. Like any other healthcare organisations, ASPH has to report cases of carbapenemase-producing organisms to Public Health England.
Key reference source and further information
For further information, please see www.gov.uk.
The Infection Prevention and Control Team,
Ashford and St Peter’s Hospitals NHS Foundation Trust,
Telephone: 01932 722544 / 722128.
Adapted from Royal Surrey County Hospital CPE leaflet