Public Health England (PHE) has published, for consultation, draft, updated guidance on the detection, management, and control of carbapenemase-producing Enterobacterales (CPE) in acute and non-acute healthcare settings.
The draft guidance, Framework of Actions to Contain Carbapenemase Producing Enterobacterales, would update information contained in two existing documents: the toolkit on CPE detection, management and control for Acute Trusts (2013), and that for non-Acute Trusts (2015).
Increasing levels of carbapenem resistance amongst Gram-negative bacteria have been recorded in recent years in the UK and globally.
CPE are of particular concern because carbapenem resistance is conferred through the acquisition of plasmid-encoded carbapenemases that have the ability to transfer within and between bacterial species and genera, PHE noted.
PHE has received and confirmed an increasing number of carbapenemase-producing Gram-negative bacterial colonisations and infections each year since 2006 and in some health and social care organisations in England, CPE is now endemic. Further spread of CPE is an increasing threat to public health and medical treatment pathways in the UK, with significant cost and operational implications for healthcare organisations, PHE said.
There were an estimated 60,788 antibiotic-resistant severe infections in 2018; equivalent to 165 new antibiotic resistant infections per day. For the seven priority bacterial pathogens reported, the rate of bloodstream infection (BSI) in 2018 was 145 per 100,000 of the population (22% increase from 2014).