Screening for Carbapenemase Producing Enterobacteriacae (CPEs) in the Pre-Operative Setting

Patient Information

Infection Prevention and Control Department

• Author ID: RN/AP
• Leaflet ref: M 002
• Version: 7
• Leaflet title: Screening for Carbapenemase Producing Enterobacteriaceae (CPEs) in the Pre-Operative Setting
• Last review: July 2023
• Expiry Date: July 2025

What are Carbapenemase Producing Enterobacteriacae (CPEs)?

Enterobacteriaceae are bacteria which usually live harmlessly in the gut of humans. CPEs are Enterobacteriaceae which are resistant to many antibiotics and therefore cannot be easily treated. CPEs are resistant to the group of antibiotics known as the carbapenems, which are often used to treat severe infections.

CPEs do not cause problems to people who are otherwise fit and healthy, and you will not normally suffer any effects from carrying CPEs. However, as infections caused by CPEs can be more difficult to treat, it is important to screen patients that may be at risk.

Why am I being screened?

The following patients will require screening:

• Those who are already known to be carrying CPE
• Those that have been an inpatient in a health care facility abroad or in another UK hospital  with a higher incidence of CPE in the last 12 months
• Those patients known to have previously shared the same bay (or ward) with a patient who has been found to be carrying CPE

How will I be screened?

CPE screening involves inserting a swab inside your rectum (bottom). Alternatively, you may be asked to provide a sample of faeces. The swab/sample will be sent to the laboratory and the result is usually available within two to three days. If the result is negative, nothing further is required.

How will I get the results?

Screening results are sent by the laboratory to the nurse in charge of the Pre-operative Clinic, who will inform you directly of the results.  The result is normally available within a week. .

What if I decline the offer of screening?

We can only take swabs from you if you give your consent to do so; however, screening is performed because it is judged to be beneficial for your health at the time of operation. We strongly recommend that you undergo CPE swabbing where advised; if your operation requires the use of antibiotics these may be changed to cover the possibility of CPEs being present. If you have any questions or concerns about this, please speak to a member of the nursing or medical staff.

What if the result is positive?

Your operation will proceed as normal, but you will be asked to remain in a single room for the duration of your hospital stay, and the staff caring for you will carry out additional infection control precautions. Antibiotic treatment to prevent or treat any infections may be more complicated when you are carrying CPEs. Any treatment will be discussed with specialists in infection control during your stay.

If I have CPE, will it ever disappear?

Sometimes the body will eventually clear CPE, but if this does not happen, it is unlikely to affect your life. If you are re-admitted to hospital for any reason, you will be asked to remain in a side room, and staff caring for you will use infection control precautions to prevent the spread of CPE. 

Advantages of CPE screening

Screening for CPE will help to identify if you are carrying CPE, ensure the appropriate treatment is given where needed, and ensure that all appropriate precautions are taken during your hospital stay to keep the risk of spread to a minimum.

Where can I find out more information about CPE screening?

If you have any further questions about screening for CPE, please speak to a member of nursing or medical staff.