Screening for Carbapenemase-Producing Enterobacterales (CPE)
20 May 2020
Screening for CPE is no longer required for direct patient transfers from Flinders Medical Centre (FMC) to healthcare or residential care facilities.
From May 2019, a cluster of CPE cases was identified at FMC with 18 confirmed cases. CPE screening was recommended for all adult patients who had spent more than 24 hours at FMC and were being directly transferred to another health or residential care facility. No cases of CPE in direct FMC patient transfers have been identified since November 2019 and ongoing CPE screening of direct patient transfers from FMC is no longer required.
CPE are bacteria that are resistant to carbapenem antibiotics (e.g. meropenem), a class of ‘last resort’ antibiotics usually reserved for treating infections with organisms resistant to commonly used antibiotics. Patients colonised with CPE can develop serious infections including urinary tract, abdominal, bloodstream and respiratory infections. CPE is transmitted via direct or indirect contact, through environmental surfaces contaminated with fomites. In Australia the major risk factor for acquiring CPE is thought to be overseas travel, especially when there is medical care in an overseas health care facility. Local transmission in health care settings has also been reported.
Management of CPE cases and contacts in healthcare and residential care facilities
- For patients identified as having CPE colonisation or infection:
- Seek advice from an infectious diseases physician or clinical microbiologist regarding appropriate medical management.
- Ensure transmission based precautions are in place if the patient is being managed in/or being transferred to a healthcare or residential care setting in accordance with local policy and procedure.
- For persons (patients or residents) identified as contacts* of a patient with CPE:
- Perform screening:
- Take a faecal specimen or rectal swab plus a groin swab.
- Request CRE screen (carbapenemase resistant Enterobacterales) on the pathology form.
- If the contact is within a healthcare or residential care facility, manage with transmission based precautions until results are available.
- Perform screening:
Doctors are reminded to:
- Notify all confirmed or suspected cases of CPE to the Communicable Disease Control Branch (CDCB) within 3 days of receiving information from the laboratory.
Diagnostic laboratories are reminded to:
- Notify all cases of CPE to CDCB, including suspected cases prior to confirmation from a reference laboratory.
- Advise the requesting doctor that CPE, including suspected cases, must be notified to CDCB within 3 days, preferably sooner.
For more information and definition of a CPE contact* see SA Health carbapenemase-producing Enterobacterales (CPE) infection control web page.
For all enquires please contact the CDCB on 1300 232 272 (24 hours/7 days)
Dr Louise Flood – Director, Communicable Disease Control Branch