Carbapenemase-producing organisms (CPOs) are multidrug-resistant and have been shown to be associated with increased morbidity and mortality. Rapid detection can guide clinical management and allow implementation of appropriate infection control procedures.
The Royal Free London NHS Foundation Trust is a tertiary referral centre with a diverse, international patient population. In April 2013, the Royal Free implemented a CPO screening programme of selected universal screening in some areas (intensive care, private, renal and liver units), together with risk factor-based screening in others (haematology, oncology, stroke and infectious disease units). In addition, any patients with identified risk factors for CPO and contacts of positive cases are screened.
The most commonly detected genotype at the Royal Free is OXA-48, followed by NDM, VIM, KPC and OXA-23. In addition, occasionally more unusual types are isolated, including IMP, IMI and GES-5.