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Backgrounder - CPE

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February 03, 2014

What are Carbapenemase-Producing Enterobacteriaceae (CPE)?
CPE refers to a common family of bacteria called Enterobacteriaceae, which are found in human intestines.  Most people who carry CPE are colonized, but not infected, meaning the organisms are present in their bodies, but are not causing any symptoms. Patients who are healthy with a strong immune system are very unlikely to be made sick by CPE. Those who become infected with symptoms due to the bacteria are usually already very ill for other reasons.

CPE can be very difficult to treat because the antibiotics doctors usually give may not work.
Where is CPE found? CPE bacteria are usually acquired through health care exposures in countries where these bacteria are commonly found. These include countries where CPE have been identified in health care facilities.

These bacteria are most likely brought back to Fraser Health by travellers to endemic areas, such as South Asia, some parts of the United States and Greece, where they are regularly found in health care settings.

What are the risk factors for CPE?
The initial risk factor is exposure to a health care facility in countries where these bacteria are commonly found. This means individuals who have had surgery, dialysis or been admitted to health care facilities affected by CPE are at increased risk of acquiring the bacteria and becoming colonized.

How are CPE infections treated?
CPE is sometimes difficult to treat because they have high levels of resistance to many antibiotics. However, there are combinations of antibiotics available to effectively treat most infections. Strains of CPE resistant to all antibiotics are very rare but have been reported internationally.

What is Fraser Health doing to reduce the risk of the organism spreading?
To reduce the risk of the organism spreading, Fraser Health has implemented a rigorous screening process for all patients admitted into our hospitals, particularly those being treated in our intensive care units. The screening process involves asking whether or not patients have been admitted into a hospital or received renal dialysis outside of Canada within the past 6 months.

Anyone who answers yes to the screening question will be tested for CPE.

Health care providers working with patients who are carriers of CPE will take extra measures to prevent spreading the organisms to other patients. This will include the use of gowns and gloves during care and cohorting patients that are colonized with CPE. It is very important for visitors and health care providers to practice good hand hygiene at all times to help keep them and our patients safe.

What can the public do to prevent the spread of CPE?

  • Inform your health care professionals if you’ve had a medical procedure done recently while travelling to an endemic country prior to a procedure or seeking treatment in a facility in Canada.
  • Wash your hands often, especially after going to the bathroom and before preparing and eating food.
  • Do not share personal care items such as towels, toothbrushes or bar soap.
  • Clean bathrooms and other frequently touched surfaces (for example, light switches and water taps) once per day and more often if visibly soiled.
  • Wash non-disposable cleaning cloths after each use.
  • Keep a clean dressing on open draining wounds
   
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