Advice after your nerve block for surgery
On this page…
What are Carbapenemase-Producing Enterobacterales?
Enterobacterales are bacteria that usually live harmlessly in the gut of humans. This is called ‘colonisation’ (a person is said to be a ‘carrier’). However, if the bacteria get into other places such as the liver, kidney or bloodstream, they can cause an infection. Carbapenems are one of the most powerful types of antibiotics. Some strains of these bacteria can produce Carbapenemases, that are enzymes (proteins), which destroy carbapenem antibiotics and so the bacteria are said to be resistant to these antibiotics.
Why does carbapenem resistance matter?
Carbapenem antibiotics can only be given in hospital directly into the bloodstream. Until now, doctors have relied on them to successfully treat certain ‘difficult’ infections when other antibiotics have failed to do so. Therefore, in a hospital where there are many vulnerable patients, the spread of these resistant bacteria can cause problems, as there may be limited or no antibiotics left to treat such patients who develop infections with such bacteria
What infections can CPE cause?
Infections present in the same way and can cause similar problems caused by antibiotic sensitive strains of these bacteria. This could be a wound or urinary tract infection, pneumonia, or a bloodstream infection. However, the infections caused by these antibiotic-resistant bacteria are more difficult to treat.
Why am I being offered screening for CPE?
If, in the last 12 months you have received medical treatment in a hospital abroad, or a UK hospital where there could have been patients with CPE, it is recommended by national guidance that you are screened for CPE. You might be nursed in a single room with ensuite facilities whilst awaiting results.
Or
Recent testing has shown that a patient in your ward has tested positive for CPE. Whilst there is no reason to believe this may have spread to other patients, it is prudent to check by offering screening. The chance of you having acquired CPE from such exposure is very low.
Or
You have been admitted to a specialised area such as critical care, renal dialysis, haematology or oncology.
Or
You have previously tested positive for CPE.
How will I be screened for CPE?
Screening usually involves taking a rectal swab by inserting the swab just inside your rectum (bottom). Alternatively, you could provide a sample of faeces. The swab/sample will be sent to the laboratory and you will be informed of the result usually within two to three days. If the result is negative no further action is required.
What happens if the result is positive?
You will be informed of the result and if the result is positive, please ask your doctor or nurse to explain this to you in more detail. You will continue to be accommodated in a single room whilst in hospital and also for future admissions. Your GP will be informed of the result on discharge and you will be offered an information card that you can present to other healthcare staff if you attend a different hospital or social care services. If you develop an infection with these bacteria, you will need to have antibiotics. However, if there are no signs of infection and you are simply ‘carrying’ the bacteria, no treatment is required.
How can the spread of these bacteria be prevented in hospital?
As you will be nursed in a single room, this will help prevent the spread of bacteria. Hospital staff involved in direct personal care will wear gloves and aprons if there is a risk of contact with blood or body fluids.
The most important measure you can take is to wash your hands well with soap and water, especially after going to the toilet. You should avoid touching medical devices (if you have any) such as your urinary catheter tube and your intravenous drip, particularly at the point where it is inserted into the body or skin. There is no risk to your visitors, but they will be encouraged to clean their hands before and after visiting.
What happens when I go home?
The presence of bacteria (which may disappear naturally with time), should not affect you or your family at home. Usual personal hygiene and household cleaning is sufficient and there are no restrictions on activities and visitors. If you have a wound and it becomes red, swollen or oozes, or you develop a fever, then please contact your GP as usual.
Contact us
If you have any queries relating to this information, please contact the Infection prevention and control (IPC) service.
About this information
Service:
Infection prevention and control (IPC)
Reference:
LL/012
Approval date:
11 September 2025
Review date:
1 September 2028
Click ‘show accessibility tools’ at the bottom of the page
Then click ‘select language’
Alternative formats
You can use the accessibility toolbar at the bottom of your screen to:
-
Change the text size
-
Adjust the font
-
Modify the colour contrast
-
Use the translate function
If you would like this information in another format, such as Braille, audio, or easy read, please speak to a member of staff.
You can also print as well as download as PDF using the “Print this page” button at the end of the page.
Staff will print a copy for you on request
Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.