The CPE bacterium (CPE stands for ‘Carbapenemase Producing Enterobacteria’), which is resistant to various antibiotics, is on the rise in our southern neighbors. The bacteria is spreading alarmingly quickly in Belgian hospitals. In the first half of 2012, a total of 206 cases were reported in Belgium, more than in all of 2011. The multi-resistant carbapenemase-producing enterobacteria pose a major threat to public health, because the therapeutic options to treat these infections are very limited, sometimes even absent . After all, CPE is a bacterium that is resistant to many antibiotics. This culprit is especially dangerous for people who are weakened.

CPE bacteria

• What is CPE?
• How is the bacteria transmitted?
• How can the spread be prevented?
• How is CPE treated?

What is CPE?

CPE stands for Carbapenemase-Producing Enterobacteria . This pathogen produces the enzyme carbapenemase , of which there are several variants and which neutralizes the effect of antibiotics – which are bactericidal medicines. The latest includes New Delhi metallo-beta-lactamase (abbreviated NDM-1), which recently appeared in no fewer than thirteen European countries, including the Netherlands. Enterobacteria are mainly found in the human intestines. The Gram-negative rod-shaped bacterium Klebsiella pneumoniae is the main supplier of the enzyme, but other intestinal bacteria, such as the well-known Escherichia coli (E. coli), have also been found that produce these enzymes. E. coli is the main cause of urinary tract infections. Only an old antibiotic, colistin, which has many side effects, or a more recent, less effective drug (tigecycline) can be used against CPE bacteria.

How is the bacteria transmitted?

CPE regularly appears in hospitals, first in Asia, but now also in Belgium. Transmission mainly takes place via the hands, currently often between patients admitted to high-risk departments, including intensive care and transplant departments.

How can the spread be prevented?

The health services have taken all kinds of measures to prevent the spread of the bacteria. Patients must be nursed in isolation and nursing staff must pay even more attention to hand hygiene. Good hand hygiene, consisting of hand cleaning, hand disinfection and hand care, among healthcare workers is considered the most important measure to reduce the risk of transmission of microorganisms from workers to patients. The effectiveness of hand hygiene – when applied properly – has been demonstrated in a large number of studies. Briefly washing your hands with soap and water is insufficient to eliminate all micro-organisms on the hands.But strict hand hygiene applies not only to all staff, but also to patients and visitors. This is to prevent transmission of germs and protect vulnerable patients against infection.If there is a risk of contact with bodily fluids, the healthcare worker must wear individual protective equipment, such as gloves, a protective apron and, if necessary, protective goggles.Disinfection of frequently touched surfaces in the patient environment is also important. It appears that a disinfection method based on atomizing hydrogen peroxide prevents the spread of the CPE. This can be done using associated equipment, which the Alpheios company in Belgium developed in collaboration with international researchers.

How is CPE treated?

Few antibiotics can combat CPE bacteria. Infections with this culprit are therefore difficult to treat. If you have an infection, the treating physician will initiate the most appropriate treatment.

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