MOLECULAR DIAGNOSTICS
England since October 2020: quarterly update, Q1 2025. (UKHSA, 2025) www.
gov.uk/government/publications/ carbapenemase-producing-gram- negative-bacteria-laboratory-surveillance/ carbapenemase-producing-gram-negative- organisms-in-england-since-october-2020- quarterly-update-q1-2025
5 Oter JA, Burgess P, Davies F, et al. Counting the cost of an outbreak of carbapenemase- producing Enterobacteriaceae: an economic evaluation from a hospital perspective. Clin Microbiol Infect. 2017;23(3):188-196. doi:10.1016/
j.cmi.2016.10.005
6 NHS England. National infection prevention and control. (NHSE, 2025) www.england.
nhs.uk/publication/national-infection- prevention-and-control/
7 UK Health Security Agency. Framework of actions to contain carbapenemase- producing Enterobacterales. (UKHSA, 2022)
www.gov.uk/government/publications/ actions-to-contain-carbapenemase- producing-enterobacterales-cpe
8
Rapid PCR enables clearer decisions on infection risk within an hour so that stroke patients can be safely placed in the correct care area sooner.
for high-risk admissions. The transition to PCR testing aligns with the recent European Centre for Disease Prevention and Control CPE risk assessment, which emphasises how prompt identification of CPE reduces opportunities for hospital transmission, and supports real-time infection and genomic surveillance.10 For patients who test positive for
CPE, or are identified as contacts of a confirmed case, an alert is added to their electronic health record. This ensures that CPE screens are performed to check for transmission while they are an inpatient and, if the patient is discharged and re-admited in the future, they can be re-screened for CPE. The system is linked across multiple hospitals and healthcare organisations, enabling automatic notifications should the patient present elsewhere. This supports consistent infection control measures and ensures continuity of care across the healthcare network.
Looking to the future The introduction of rapid, near-patient PCR testing for high-risk admissions and selected discharges within the stroke care pathway at UHCW has significantly accelerated confirmation of patient CPE status, reducing turnaround times for results from days to hours. This has helped to alleviate pressure on side-room occupancy and improve antimicrobial stewardship, minimising resource use and streamlining clinical decision-making. Following the success of the initial
implementation, CPE PCR testing has now been fully integrated into the stroke unit, and this approach has been extended into other departments within the trust. Overall, the implementation of near-
patient testing for MDR organisms represents a significant step forward in patient care, by providing a clear clinical picture regarding colonisation and allowing more targeted IPC measures. However, realising these benefits requires strong cross-departmental collaboration, supported not just by laboratory and clinical teams, but also IPC and IT staff, and funded through central hospital budgets to provide overall savings and enhanced patient care.
References 1 World Health Organization. Antimicrobial
resistance. (WHO, 2023)
www.who.int/news- room/fact-sheets/detail/antimicrobial- resistance
2 GBD 2021 Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050. Lancet. 2024;404(10459):1199-1226. doi:10.1016/S0140-6736(24)01867-1
3 Guest JF, Keating T, Gould D, Wigglesworth N. Modelling the annual NHS costs and outcomes atributable to healthcare-associated infections in England. BMJ Open. 2020;10(1):e033367. doi:10.1136/bmjopen-2019-033367
4 UK Health Security Agency. Research and Analysis: Carbapenemase- producing Gram-negative organisms in
24
WWW.PATHOLOGYINPRACTICE.COM February 2026
Jenkins DR, Auckland C, Chadwick C, et al. A practical approach to screening for carbapenemase-producing Enterobacterales- views of a group of multidisciplinary experts from English hospitals. BMC Infect Dis. 2024;24(1):444. doi:10.1186/s12879-024-09307-y
9 Bai Y, Hao Y, Shao C, Wang Y, Jin Y. Accuracy of Xpert Carba-R Assay for the Diagnosis of Carbapenemase-Producing Organisms from Rectal Swabs and Clinical Isolates: A Meta-Analysis of Diagnostic Studies. J Mol Diagn. 2021;23(11):1534-1544. doi:10.1016/j. jmoldx.2021.08.006
10 European Centre for Disease Prevention and Control. Rapid risk assessment – Carbapenem-resistant Enterobacterales – third update. (ECDC, 2025) www.
ecdc.europa.eu/en/publications-data/ carbapenem-resistant-enterobacterales- rapid-risk-assessment-third-update
PPi
11 Department of Health and Social Care. UK 5-year action plan for antimicrobial resistance 2019 to 2024. (
GOV.UK, 2019)
www.gov.uk/government/publications/ uk-5-year-action-plan-for-antimicrobial- resistance-2019-to-2024
Dr Natasha Ratnaraja is a Consultant Microbiologist at University Hospitals Coventry and Warwickshire NHS Trust, and Chair of the Medical Microbiology and Medical Virology Specialty Advisory Commitee at The Royal College of Pathologists.
Katie Jones is a Clinical Scientist Infection Specialist at University Hospitals Coventry and Warwickshire NHS Trust.
Findings are specific to the institution where they were obtained and may not reflect results achievable at other institutions.
Cepheid
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