Recommendations for detection and rapid management of carbapenemase-producing Enterobacterales outbreaks

R Puleston; C S Brown; B Patel; C Fry; S Singleton; J V Robotham; R Freeman

doi:10.1016/j.infpip.2020.100086

Recommendations for detection and rapid management of carbapenemase-producing Enterobacterales outbreaks

Infect Prev Pract. 2020 Sep 1;2(3):100086. doi: 10.1016/j.infpip.2020.100086. eCollection 2020 Sep.

Authors

R Puleston¹, C S Brown^{2

3}, B Patel⁴, C Fry², S Singleton⁵, J V Robotham^{2

6}, R Freeman^{2

4}

Affiliations

¹ Field Service East Midlands, National Infection Service, Public Health England, Nottingham, UK.
² Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, 61 Colindale Avenue, London, UK.
³ Department of Infection, Royal Free Hospital, Pond Street, London, UK.
⁴ National Infection Service, Public Health England, London, UK.
⁵ Chief Nurse's Office, Public Health England, London, UK.
⁶ NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK.

Abstract

There is large heterogeneity in approaches to tackling nosocomial outbreaks caused by carbapenemase-producing Enterobacterales (CPE), however there is limited guidance on how to approach their management. Rapid and robust infection prevention and control interventions can be effective in preventing and reducing the impact of outbreaks in healthcare environments. We present a stepwise approach to aspects of CPE outbreak management, including the development of an action plan, engagement and communication with key stakeholders, developing a dynamic risk assessment, and staff education. These can provide a blueprint for organisations to create templates and checklists to inform their own outbreak response.