NSW Health has developed new tools for monitoring and responding to CPE, including:
What are carbapenemase-producing Enterobacterales?
Carbapenemase-producing Enterobacterales (CPE) are bacteria that are likely to be resistant to most antibiotics.
Enterobacterales are a type of bacteria (known as Gram-negative bacilli, such as E. coli and Enterobacter), which live naturally and harmlessly in people’s guts, along with billions of other bacteria.
Rarely, and mainly in people with underlying serious disease, they can invade the blood or tissues and cause serious infections, including in the blood, lungs, urinary tract and wounds.
Carbapenems are a class of broad spectrum β-lactam antibiotics which are highly effective against most Gram-negative infections. Carbapenems are important in the treatment of infections resistant to most other antibiotics.
Carbapenemase is an enzyme that some bacteria produce, which make them resistant to important antibiotics, including carbapenems.
Why are CPE important?
CPE are resistant to carbapenem antibiotics, due to the presence of a carbapenemase gene usually acquired from other bacteria. This gene allows CPE to produce carbapenemase enzymes which destroy carbapenems and other important β-lactam antibiotics such as penicillins and cephalosporins. Antibiotic treatment options for CPE are therefore limited.
What is CPE colonisation?
Like other Enterobacterales, CPE mostly live harmlessly in the gut (colonisation). Rarely, they can cause infection.
CPE colonisation refers to the presence of the bacteria in or on a person’s body without signs of invasive infection. CPE colonisation mostly occurs in the lower gastro-intestinal tract. Occasionally other sites, such as the urinary tract, can become colonised.
What is CPE infection?
CPE infection refers to the invasion of a person’s bodily tissues by the bacteria, resulting in disease.
CPE are an infection risk for the following reasons:
- CPE can be transferred between patients. CPE have caused a number of outbreaks in health care facilities nationally and overseas
- Carbapenemase genes can be efficiently transferred between different types of bacteria, including commensal bacteria in the gut
- CPE infections are associated with high rates of illness and can be fatal
- CPE are difficult to treat. The antibiotics that are effective may have significant side effects