MOLECULAR DIAGNOSTICS
Using rapid diagnostics to streamline CPE infection control
University Hospitals Coventry and Warwickshire NHS Trust recently saw a cross-team collaboration which led to the successful rollout of near-patient CPE testing with rapid PCR diagnostics for stroke patients. Consultant microbiologist Dr Natasha Ratnaraja and clinical scientist infection specialist Katie Jones describe how this new technology has benefitted the high-risk care pathway.
University Hospitals Coventry and Warwickshire (UHCW) NHS Trust is a regional centre for stroke care, handling a steady influx of patients transferred from neighbouring hospitals. This high volume of admissions makes fast and effective infection control vital to protect specialist bed capacity and avoid treatment delays. Rapid screening for carbapenemase- producing Enterobacterales (CPE) and other drug-resistant organisms plays a key role in this effort. The introduction of rapid testing has
streamlined patient triage, accelerated clinical decision-making, optimised side- room use and reinforced antimicrobial stewardship best practices. The initiative has also strengthened outbreak responses and improved continuity of care between trusts, highlighting the broader reach of rapid diagnostics in managing drug- resistant infections.
Urgency of CPE The ever-increasing threat posed by antimicrobial resistance (AMR) represents a serious challenge for healthcare providers, and the World Health Organization (WHO) has declared AMR as one of the top threats to public health worldwide.1
with 4.71 million deaths globally,2
In 2021, AMR was associated and the
financial burden of healthcare-associated infections is substantial, costing £2.7 billion annually in the UK alone.3 Carbapenemase-producing
Enterobacterales are multidrug-resistant (MDR) bacteria that pose a significant threat in healthcare setings, due to their resistance to last-line antibiotics and potential for rapid transmission. The group includes some of the most common bacterial species found in hospitals, including Escherichia coli, Enterobacter spp, and Klebsiella spp. These bacteria spread quickly via direct person-to-person contact or contact with contaminated surfaces in high-density populations like hospitals, and can cause serious infections such as urinary tract infections, pneumonia and sepsis. Infections caused by CPE are particularly difficult to treat because they are not only resistant to commonly used antibiotics, but also able to produce carbapenemase enzymes that degrade carbapenems – traditionally the last- line antibiotics for Gram-negative bacteria. Between October 2020 and March 2025, there were 22,237 acquired carbapenemase-producing organism (CPO) episodes reported to the UK Health Security Agency (UKHSA).4
The same
CPE outbreaks have the potential to disrupt patient flow and contribute to longer hospital stays, often requiring prolonged isolation and complex care pathways.
report states that, of the five major carbapenemase genes, the most reported between Q2 2024 and Q1 2025 was New- Delhi metallo (NDM; 36.3%), followed by
February 2026
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