Framework of actions to contain carbapenemase-producing Enterobacterales

This framework focuses on carbapenemase-producing Enterobacterales
(CPE) because these organisms spread rapidly in healthcare settings and
leading to poor clinical outcomes because of limited therapeutic options.

The increased incidence of CPE has significant cost and operational implications for healthcare providers.

Unless action is taken, learning from experiences elsewhere in the world,
rapid spread of CPE will pose an ever-increasing threat to public health and
medical treatment pathways in the UK.

The framework sets out a range of measures, that if implemented well, will
help health and social care providers minimise the impact of CPE. These
include:

• active patient admission screening of risk groups
• rapid detection of patients colonised or infected with CPE to enable
  spread, with appropriate surveillance systems to capture this
• prompt recognition of outbreaks and clusters to enable effective
  management
• consistent implementation of infection prevention and control
  practices
• minimisation of CPE reservoirs by effective environmental cleaning
  and decontamination
• antimicrobial stewardship programmes to minimise inappropriate use
  of broad spectrum antibiotics, including carbapenems
• optimised laboratory methods to detect carbapenemase producing
  bacteria
• organisational ownership to support the implementation of this
  framework.

This document recognises that the evidence base for some
recommendations is limited and that local risk assessment is important for
building a local CPE policy that can be implemented based on the
Framework.