CPO (Carbapenemase-producing organisms)

Carbapenemase-producing organisms (CPO) are a group of bacteria (germs) that have become resistant to many antibiotics, including a type of antibiotic called carbapenems. The CPO produce an enzyme called carbapenemase that makes the antibiotic no longer effective in fighting infections. Carbapenems are powerful antibiotics used to treat serious infections.

This group of bacteria include Enterobacterales (found in human and animal gut), Pseudomonas aeruginosa (found in soil and water) and Acinetobacter baumanii (found in soil, water and on human skin). 

Some people carry CPO in their gut, respiratory tract or on their skin without developing an infection or becoming sick. These people are said to be colonised and do not require any treatment. If CPO moves to another part of the body, you may develop an infection and require treatment. CPO can cause urinary tract, bloodstream and wound infections, or pneumonia. Infections due to CPO can be difficult to treat.

Who can have CPO?

People are more likely to carry CPO or get an infection if they have:

• been hospitalised overseas or travelled to a country where CPO are common
• recently had a long hospital stay, been in intensive care or had complex surgery
• had CPO before or been in contact with others who have a CPO
• been treated with antibiotics for a long time, or used a lot of different antibiotics
• had chemotherapy in the last 12 months
• an indwelling medical device, such as a urinary catheter in place.

How do you get CPO?

CPO is usually spread from person to person through contact with hands or equipment with CPO on them or from touching contaminated environmental surfaces. CPO is not spread through the air by coughing or sneezing. You can spread or pick up CPO in the community or in hospital.

Can CPO be treated?

Yes. People with an infection caused by CPO may require antibiotics and this is best managed with advice from a specialist doctor who can help identify the best antibiotic treatment.

Preventing the spread in hospital if you have CPO

Finding CPO on people who carry CPO is essential to stop any spread. This is why we screen for CPO in WA hospitals. If someone has a history of being in a hospital or residential care facility, overseas in the last 12 months, a specimen to look for CPO (either a stool sample or a rectal swab) will be collected when they are admitted to hospital.

What happens if I have CPO?

If CPO is found in a specimen taken from you, your healthcare team will continue to provide the same level of care. However, the following extra precautions will be taken while you are in hospital to reduce the risk of spreading CPO to other patients:

• you will be cared for in a single room with your own toilet and a sign may be placed on your door to remind others who enter your room about the precautions e.g. to wear a gown and gloves
• an alert will be placed against your name in the hospital computer system that can be seen by all public hospitals in WA. This will let staff know at the time of future admissions that extra precautions are required
• as there is no method for this information to be shared with WA private hospitals, residential care facilities or hospitals outside of WA, it is important you advise these health providers that you have acquired a CPO.

You can help prevent spreading CPO to other patients by:

• regularly washing your hands with soap and water, or using an alcohol-based hand rub
• staying in your room unless you are moved for tests or treatment.

Can I have visitors in hospital?

Your family and friends can visit, but to prevent the spread of CPO, it is important that all visitors:

• always wash their hands with soap and water or use an alcohol-based sanitiser before entering and leaving your room
• do not eat or drink in your room
• do not use your hospital bathroom.

People with long-term health problems can become very unwell if they get CPO infection, so talk with your doctor, nurse, or midwife if someone with a long-term health problem is planning to visit.

What will happen at home?

There is no need to take additional precautions at home, but it is important that you and your family members remember these good hygiene practices to prevent the spread of CPO to other people:

• always wash your hands with soap and water:
  • after going to the toilet
  • before preparing meals and eating food
  • before and after touching any wounds or lesions or medical devices you may have.
• use your own towels and face cloths and do not share them
• do not share grooming items, such as brushes, nail scissors, or razors
• cover any skin wounds if possible.

No special cleaning is required in your home and your clothing may be laundered as usual, along with the rest of the household laundry. All eating utensils and dishes can be washed in the normal way. You can return to work. It is important to tell other healthcare providers about your positive test result for CPO so they can organise the best care.

More information

• ask your doctor, nurse/midwife or speak with someone from the hospital’s infection prevention and control team.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.