Defining the burden and optimal clinical management for multi-resistant Gram negative infection

South LondonInfection
Start Date: 1 Jan 2013 End Date: 30 Sep 2019

Defining the burden and optimal clinical management for multi-resistant Gram negative infection

Carbapenem resistant bugs

Researchers want to develop better ways of preventing and managing infection caused by Gram negative (GN) bacteria – both in hospitals and in the community.

One large group of GN bacteria is called Enterobacteriaceae and includes E.coli and Klebsiella. These bugs live in the gut of all humans and animals without doing any harm, but can cause serious infections if they spread to other parts of the body, or get into the bloodstream.

Some types of Enterobacteriaceae have become resistant to carbapenem antibiotics, used by doctors to treat infections caused by GN bacteria when other antibiotics have failed. This means infections caused by this type of bacteria become much more difficult to treat.

A number of different acronyms are used to described bacteria that are resistant to these strong antibiotics. The acronyms include ‘CPE’ (carbapenemase-producing Enterobacteriaceae); ‘CROs’ (carbapenem resistant organisms); and ‘CRE’ (carbapenem-resistant Enterobacteriaceae).

Public Health England advice

In March 2014, Public Health England launched a ‘toolkit’ for hospitals to help them detect, manage and control infections caused by CPE(1). NHS England and Public Health England have asked all NHS trusts to implement the recommendations in the toolkit(2),(3). Hospitals are asked to screen people who are admitted to hospital to see if they are carrying CPE if, within the previous 12 months, they have previously tested positive, been hospitalised abroad, or admitted to a UK hospital that has experienced a spread of infections caused by these bacteria.

But research carried out at Centre for Clinical Infection and Diagnostics Research (CCIDR) (at the Department of Infectious Diseases, King’s College London and Guy’s and St Thomas’ NHS Foundation Trust) suggests that these screening criteria may need to be re-visited.

Dr Tim Planche