AmpC

What is an AmpC?

AmpC is an enzyme produced by some bacteria such as E-coli and klebsiella that makes them resistant to certain antibiotics- so infections may be more difficult to treat. These bacteria usually live harmlessly in the gut, but they can sometimes cause infections.

What infections can AmpC cause?

The most common infections caused by AmpC are urinary tract, but they can cause other infections including pneumonia, wound, abdominal and infections in the blood. Sometimes people carry AmpC bacteria in their gut, urine and on the skin for example, without any symptoms. This is known as “colonisation” and does not usually require antibiotic treatment, as it is not causing infection.

How do I get an AmpC?

It is often hard to know exactly where or how someone picked up a bacteria. People receiving lots of different antibiotics are more likely to develop resistant strains of bacteria such as AmpC.

AmpC can be spread through person-to-person contact, through sharing items with a person that has the bacteria or through contact with a contaminated surface or equipment.

Who is at risk of infections caused by an AmpC?

Certain risk factors are associated with carrying AmpC bacteria including:

• Medical devices such as urinary catheters and cannulas.
• Wounds and surgical incisions.
• Frequent and repeated use of antibiotics (which can allow resistant bacteria to grow).
• Frequent/prolonged hospital stays.
• Weakened immune system.

What happens if I am colonised with an AmpC or have an infection?

When in hospital you may be cared for in a single room with an ensuite toilet. Hospital staff will wear aprons and gloves to care for you and perform appropriate hand hygiene.

It might not always be possible to be cared for in a room on your own and depending on a risk assessment you may be nursed in a bay with similar precautions.

These bacteria may stay in the body for months, but antibiotics are not required unless you get an infection.

How can I prevent the spread of AmpC’s?

Both colonised and infected people can spread the bacteria. It spreads more easily in patients with diarrhoea. AmpCs can enter the body through open wounds and devices.

Hand washing is important to stop the spread of resistant bacteria.

• Regularly wash your hands with soap and water, especially after going to the toilet and before eating (staff will assist you if you need help).
• Use alcohol hand sanitiser (alcohol gel), available on the ward, when your hands are visibly clean. Soap and water hand wipes can also be used.
• Avoid touching medical devices if you have them, such as urinary catheters, intravenous cannulas, and wounds.
• Let the nursing staff know if you develop diarrhoea.
• Your room or bed area will be cleaned once a day – please help the domestics by keeping your room tidy and placing your belongings in the bedside cabinet provided.

All hospital staff should perform hand hygiene when they enter and leave your room or approach your bedside.

Will I have to stay in hospital longer?

Unless you develop an infection, you will not necessarily need to stay in hospital longer. However, if you do develop an infection, some of the antibiotics used to treat AmpC infections are given via injection, so you might need to stay in hospital whilst the infection is being treated.

How are AmpC’s treated?

• Not all patients with AmpCs need treatment. Sometimes the bacteria live in the gut, urine or wound, for example without causing infection.
• Although AmpC’s are resistant to some antibiotics, other antibiotic options are available should treatment be required for an infection.
• Your doctor or GP will only prescribe antibiotics for an infection, as careful use of antibiotics is essential in reducing the risk of bacteria developing resistance.
• If antibiotics are needed whilst you are an inpatient, these will be prescribed using the hospitals antibiotic guidelines and monitored closely.

Is there any risk to my family/visitors?

AmpCs are not usually a problem for healthy people. Visitors should wash their hands or use alcohol-based hand rub (hand gel) before entering the patient’s room and again when leaving. If visitors are helping with your personal care, the nursing staff may advise extra precautions, such as gloves and aprons.

What advice should I follow at home?

Good hand hygiene is important after you leave hospital. There is no need to take special precautions at home. Normal household cleaning practices, including your laundry should be in place.

Please tell healthcare workers that you are colonised with an AmpC bacteria if:

• You are seeing new doctors.
• Attending a different hospital.
• You return to hospital.
• You should tell your GP.

This will help ensure you get the most effective antibiotics if you subsequently develop an infection.

If you are discharged on antibiotics, it is important that you complete the course prescribed. The AmpC result will be on the discharge summary from UCLH, to inform your GP.

Where can I get more information?

• Talk to the medical or nursing team caring for you.
• You can ask to talk to the Infection Prevention and Control Team

Contact details

• Infection Prevention and Control Team Direct line: 0203 447 9716 or 0203 447 9082
• Website: www.uclh.nhs.uk