MOLECULAR DIAGNOSTICS
teams the tools they need to reduce potential transmission windows, and to initiate targeted contact tracing and environmental cleaning protocols far more quickly, reducing the likelihood of MDR pathogen clusters progressing to full-blown outbreaks. From a patient perspective, rapid testing allows them to know their carrier status sooner. This helps to alleviate the anxiety commonly felt by patients when they are contact traced after being exposed to CPE and are awaiting their result.
Given the frequent movement of patients into the stroke unit from other hospitals, and back into community setings upon discharge, there is also an increased risk of CPE transmission beyond the hospital itself.
OXA-48-like (34.4%) and K. pneumoniae carbapenemase (KPC; 19.6%).4
Need for rapid diagnostics Outbreaks involving CPE can cost individual NHS trusts hundreds of thousands of pounds both directly and indirectly. These costs include anti-infectives, environmental decontamination, missed elective surgeries and bed closures.5
– is essential in minimising the spread of MDR organisms within hospitals. National guidance from both the UKHSA and NHS England has underscored the importance of timely identification and appropriate isolation to prevent nosocomial transmission6,7
Real-world impact: a streamlined stroke care pathway University Hospitals Coventry and Warwickshire (UHCW) NHS Trust serves over one million people across the West Midlands, with more than 1,000 beds across its two main hospital sites. It manages an extensive acute referral network, particularly for stroke, trauma and patients requiring specialist tertiary care. UHCW operates a Hyper-Acute Stroke Unit (HASU) and an Acute Stroke Unit (ASU), acting as the treatment hub for all suspected strokes in the region. Following treatment in the HASU, patients will be transferred to the ASU, their local trust, rehab unit or community services, or return home depending on individual needs.
and, with this For example,
a recent outbreak of an NDM-producing K. pneumoniae across five hospitals in West London – affecting 40 patients – was estimated to cost around £1 million.5
In
addition to their financial impact, CPE outbreaks have the potential to disrupt patient flow and contribute to longer hospital stays, often requiring prolonged isolation and complex care pathways. Reducing the time to detection of CPE can therefore have a significant impact on preventing transmission, treatment decisions, and patient outcomes. Early detection and containment are therefore vital, particularly in high throughput setings like stroke care units. Traditional CPE screening via culture methods can take up to 72 hours to yield actionable results, delaying triage decisions and prolonging unnecessary isolation. This delay also limits the timely use of infection prevention practices for CPE, leading to potential increases in transmission. These limitations are especially critical in emergency and acute care pathways, where rapid clinical decisions are essential. Accurate and early detection of CPE – as well as other infectious organisms like TB and MRSA
in mind, a group of multidisciplinary experts from hospitals across England recently met to discuss practical solutions for implementing CPE screening recommendations into operational and clinical workflows.8
This centralised stroke pathway A key recommendation
of this meeting was for all UK hospitals to introduce rapid molecular-based methods for CPE screening to reduce unnecessary isolation and associated costs.8
Molecular testing advantage Many NHS trusts have already turned to rapid molecular diagnostics to improve detection and containment of drug- resistant pathogens – including CPE – as these assays can provide results within a mater of hours, rather than days. This offers substantial gains in terms of operational efficiency and antimicrobial stewardship. From a clinical perspective, this empowers clinicians by identifying the carrier status of a patient. If the patient develops an infection, knowing that they carry CPE could be advantageous when selecting empirical therapy. It also helps to improve resource allocation and patient flow through the care pathway, reducing non-specific antibiotic use and minimising unnecessary isolation of high-risk patients. Rapid molecular testing also gives infection prevention and control (IPC)
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WWW.PATHOLOGYINPRACTICE.COM February 2026
for the region means that the stroke service at UHCW receives high volumes of referrals, often accepting patients from multiple feeder hospitals across the West Midlands. Patients presenting to the stroke service are often considered high CPE risk because they have been referred from other hospitals, have had a recent admission to a different trust within the past 12 months, or have been repatriated from abroad. Where possible, these high-risk patients are pre-emptively placed in side rooms until their CPE status can be determined – to minimise the risk of transmission – but these rooms are in incredibly high demand, especially during busy periods. This issue is exacerbated during periods of winter pressure, as spikes in viruses such as influenza and norovirus increase the demand for side rooms, elevating the risk of introducing CPE-positive patients into the hospital environment. Given the frequent movement of patients into the stroke unit from other hospitals, and back into community setings upon discharge, there is also an increased risk of CPE transmission beyond the hospital itself. There was therefore a clear need for fast and accurate determination of CPE status to allow rapid admission, prevent transmission and optimise side-room occupancy.
AdobeStock / Nigel Harris
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