Inside the Fight Against CPE: How Rapid Diagnostics Aid Hospitals

A Growing Threat Across European Healthcare

Carbapenemase-producing Enterobacterales (CPE) are among the most concerning antimicrobial-resistant organisms in European hospitals. These bacteria, which produce enzymes like KPC, OXA-48, NDM, VIM, and IMP, can make last-line antibiotics useless. As a result, infection-control priorities are changing across healthcare systems. Dr. David R. Jenkins, Consultant Medical Microbiologist and Infection Prevention Doctor at University Hospitals of Leicester NHS Trust, describes the challenge as urgent and personal.

Dr. Jenkins also pointed out that the financial burden is significant. Each CPE case can cost hospitals between $22 000 and $66 000, and some outbreaks in Europe have cost more than €1.1 million¹. To put these figures into perspective, investing in rapid diagnostics and preventative measures could potentially translate these costs into considerable savings per avoided infection or bed-day conserved. This highlights the value of allocating resources toward these areas, transforming raw expense numbers into tangible value by preventing disruptions, accelerating patient care, and alleviating the stress on already strained infection-control teams.

When an Outbreak Hits: Lessons from Leicester

Leicester NHS Trust experienced this reality firsthand during an OXA-48 outbreak in 2018. It spanned 12 wards and required the screening of more than 900 patients¹. This event exposed the limitations of culture-based detection. Delays in identifying carriers made it difficult to prevent in-hospital transmission, especially when there was a shortage of isolation rooms. As Dr. David R. Jenkins recalls, the team had to rely on cohort nursing and rigorous containment measures to keep pace.

A turning point: PCR-based screening.

The turning point came with the adoption of rapid PCR-based screening. This allowed same-day results and shifted most new detections to the point of patient admission, rather than later in their stay. This was a critical factor in breaking transmission chains.
Today, PCR screening remains standard practice for patients with previous hospital exposure, reducing identification time to zero days. Post-outbreak surveillance still reveals persistent carriage in some individuals, but far fewer infections, demonstrating how rapid diagnostics can reshape both response and prevention. Alongside enhanced cleaning, hand hygiene, and antimicrobial stewardship, proactive measures such as pre-emptive isolation, active screening, and cohorting have become core components of Leicester’s strategy.

What's next in CPE control?
The next chapter in CPE control is emerging through genomics. Next Generation Sequencing (NGS) is uncovering hidden transmission pathways and helping hospitals understand how outbreaks evolve across wards or even between facilities. While new antibiotics targeting CPE exist, their high cost and the inevitability of resistance over time make prevention more valuable than ever.

Strengthening Preparedness Through Early Detection

As CPE continues to spread within hospitals, the experiences in Leicester underscore a fundamental transformation in infectious-disease preparedness: rapid diagnostics have transitioned from a supplemental tool to an essential component of their hospital response. In the Leicester experience, this shift was associated with earlier detection and fewer hospital acquisitions. Collectively, these outcomes demonstrate that rapid diagnostics are indispensable in confronting the persistent threat of antimicrobial resistance and in maintaining the resilience of healthcare systems.