Carbapenemase-producing Enterobacteriaceae (CPE)
Resistant bacteria, both pathogenic and non-pathogenic, occur everywhere. They occur in greater numbers in settings where antibiotics are being used and where genetic material can be exchanged between bacteria: in humans, animals and the environment. Person-to-person transmission occurs usually via the hands (e.g. following contact with stool or infected wounds).
Resistant organisms can also be transmitted to humans through contact with livestock. In the environment, they can be transmitted to edible plants such as fruit and vegetables by contaminated water, for example. Furthermore, when animals are slaughtered, resistant bacteria may colonise the raw meat. Meticulous hand hygiene when handling raw meat as well as in daily life in general are fundamental to effective prevention.
For the purposes of monitoring the resistance situation in Switzerland, a reporting requirement is being introduced for certain antibiotic-resistant bacteria that represent a threat to public health. Enterobacteria that are resistant to the carbapenem group of antibiotics are being isolated with increasing frequency. Bacteria can develop this type of resistance either when their own genetic material mutates or when they acquire resistance genes from other bacteria. Since 1 January 2016 it is mandatory to report CPE and since 1 January 2019 all positively tested samples or isolates must be sent to the National Reference Centre for Emerging Antibiotic Resistance (NARA) designated by the FOPH for characterisation of resistance.
Under certain conditions, Enterobacteriaceae can cause infections such as urinary tract infections, peritonitis, pneumonia, sepsis or wound infections. They are transmitted by direct or indirect contact (faecal-oral route) and can also be acquired in hospitals.
CPE represent a serious problem for public health because they are resistant to all β-lactam antibiotics (penicillins, cephalosporins, monobactams and carbapanems). The available figures indicate that while pathogens of this type are still rare in Switzerland, they are spreading rapidly worldwide.This form of resistance is being attentively monitored in close collaboration with the Swiss Centre for Antibiotic Resistance (anresis.ch) and the NARA. With the founding of NARA it is now also possible to carry out nationwide genotyping of CPE.