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Addressing the Global Spread of Carbapenemase-Producing Enterobacteriaceae in the UK

This study explores the potential impact of overseas patients on the spread of multidrug-resistant Gram-negative bacteria in the UK. It delves into the epidemiology, transmission rates, and interventions required to combat this serious threat to healthcare. The research emphasizes the need for improved global intelligence, antimicrobial stewardship, and infection control measures.

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Addressing the Global Spread of Carbapenemase-Producing Enterobacteriaceae in the UK

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  1. Global Travel – who goes?

  2. Global Links of NDM to the UK Kumarasamy et al., Lancet Infect Dis 2010 10:597-602

  3. 15 million Visitors to the UK 2011

  4. Visitors to the UK by Purpose – potential for MDR GN household spread

  5. Potential Impact of Overseas Patients *HES Data ** P. Wilson Pers Comm

  6. Carbapenemase-producing Enterobacteriaceae in the UK(n = 1659) Imported & ‘home grown’ Early cases often imported Neil Woodford: AMRHAI, Unpublished data

  7. Currently very limited knowledge on basic epidemiology. • CRO carriage rates in specific high risk groups allowing targeted screening? • Duration of carriage? • Optimal method of patient screening – rectal swabs – reliability of self swabbing? • Optimal laboratory screening method? • Transmission rates in home/hospital? • Efficacy of decolonisation and isolation? • Cost effectiveness of interventions?

  8. Concerted Action Required: ALL Sectors Improved Global Intelligence Cross Cutting Antibiotic Policy Surveillance Targeted & Structured Antimicrobial Stewardship • Centralised • Reporting • incl private sector Simpler cheaper laboratory tests • Aggressive Infection ..Control • Screening • Isolation • Reinforced Hand ..Hygiene • Contact precautions Unified Strategic Policy in DH/NHS Renewed Drug Pipeline Political Commitment & Investment Focussed Clinical Research 9

  9. What is the key priority ?Refocus NHS Infection Prevention and Control onto MDR GNB

  10. Serious threat to routine care in the NHS

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