Carbapenemase Producing Organisms (CPO)

You are at increased risk of getting a CPO if you have been in a hospital abroad. Other risk factors include frequent healthcare contact (such as dialysis), having multiple courses of antibiotics and being a resident of a care home or rehabilitation unit. 

If a sample is required, a healthcare professional will discuss this with you. Routinely, a rectal swab is required as this is the best way to get a result.

How will the swab be taken?

• Once gaining your consent, the procedure will be carried out in privacy.
• A swab with a cotton head will be used and inserted about 2.5cm (for adults) into your back passage for faecal (stool) flora. The swab will then be sent to the hospital laboratory. Your privacy and dignity will be respected at all times.
• One rectal swab is required on admission

What if I refuse to have a rectal swab taken?

• We will ask you to give a sample of faeces (stool) to send instead.

How long does it take for the result to come back?

• The swabs will be sent to the laboratory where they will be tested to see which bacteria grow and a healthcare professional will inform you of the result. It will take approximately one to four days for the result or longer in some instances.
• While the sample is pending, you may be cared for in a single room or with measures at the bedside to prevent the spread of infection.

If a sample tests positive for CPO, the following will be put in place:

• You will be cared for in a single room with en-suite facilities.
• Staff caring for you will wear protective equipment such as aprons/gowns and gloves to prevent the spread to other patients.
• It is very important that all healthcare staff and visitors clean their hands with either soap and water or alcohol gel before entering and leaving your room.
• Your room will be cleaned once a day, please help the domestics by keeping your belongings in the bedside cabinet provided.

It is important you wash your hands with soap and water, especially after toileting and before eating/drinking (staff will assist you if you need help). 

You should avoid touching any invasive devices you may have such as catheters, drips and wounds (if you have any). 

If you are simply colonised with CPO, it will not be treated. However, if you develop an infection caused by CPO, you will be given appropriate antibiotics. Your doctor will discuss the best choice of antibiotic with a Microbiologist.

• CPO are not a problem for fit and healthy people so friends and family can visit you.
• Visitors will need to adhere to the instructions from the nurses and wash their hands when leaving your room.
• Visitors who are feeling unwell should not visit you. If they have had a recent illness, please check with the nurse in charge first. Children and babies are more vulnerable to infection.

If you are admitted or attend an outpatient appointment and you have had a CPO-positive test, it is important that you inform the staff caring for you.

• If you are discharged home from hospital with a CPO it should not affect you or your family home. Staff from the hospital will inform your GP about your CPO result.
• It is important that you wash your hands with soap and water after going to the toilet and before eating.
• Good hand hygiene with soap and water is strongly encouraged for anyone involved in your care.
• If you have any medical devices, for example a urinary catheter, you should not touch them unless cleaning them.
• You should ensure your bathroom and toilet at home are cleaned regularly with your usual cleaning products.
• Crockery can be washed as normal. Your laundry should be washed at the hottest temperature suitable for the fabric. If soiled, the linen should be washed at 60 degrees centigrade.

Speak to the nurse looking after you, or the Ward Sister/Charge Nurse. They may contact the Infection Control Team for more information.