Hospital ‘superbug’ – ”carbapenemase-producing enterobacteriaceae” (CPE)


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Sleep Walking in Super bug Crisis


Doctors are unsure how many patients have been killed by carbapenemase-producing enterobacteriaceae.

Hospitals in England are not required to officially report infections of a “superbug” capable of resisting our most powerful antibiotics, a BBC investigation has found.

Cases of “carbapenemase-producing enterobacteriaceae” (CPE) have shown a sharp rise.

Public Health England said a lack of mandatory reporting made assessing the true extent of the problem difficult.

But Chief Medical Officer Sally Davies said laboratories did share data.

CPEs are bacteria that have the ability to make an enzyme which can fight off carbapenem antibiotics – drugs usually prescribed by physicians when patients have serious infections unresponsive to other antimicrobial medicines.

Until 2007, monitoring authorities were seeing only three to five samples per year from referrals by hospital labs across the UK.

But numbers have risen sharply since then.

Eight hundred samples of CPE were sent to Public Health England (PHE) laboratories by hospitals for analysis in 2012.

‘Mandated referral’Thousands of patients elsewhere in the world, including in countries with advanced health care systems like America, have died from untreatable infections.

In England, hospital trusts have a legal duty to report cases of MRSA and C. difficile, but these have seen a significant decline following measures to control them, enforced by the government.

No similar obligation exists for CPEs, despite concern these organisms present a greater threat.

The head of PHE’s antibiotic resistance laboratory, Prof Neil Woodford, said an “accurate handle on the extent of the problem” was needed.

He said: “I think we do need to move to a system for mandated referral and for active surveillance of these highly resistant organisms.

“If the carbapenems fall, there are very few antibiotics left in reserve. We need to take steps now to ensure that we have carbapenems that remain active for future generations.”

Central Manchester University Hospitals NHS Foundation Trust revealed it was seeing about 10 cases a week of people who are carriers of CPEs.

The Trust has an active monitoring programme for CPEs, having become, in 2009, the first in England to have an issue with these “superbugs”.

It has stepped up infection prevention and control measures.

Since then other hospitals across the UK have had similar cases.

Not everyone gets ill because the drug-resistant bacteria can be present harmlessly in our gut.

But carriers can infect others if the microbes get into a wound. 

A podcast offering Radio 4’s award winning, flagship investigative series File on 4.

England’s Chief Medical Officer says Superbugs which can’t be treated by antibiotics are as big a threat as terrorism. Allan Urry asks if the NHS is able to cope.

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This article was originally posted in | Allan Urry


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