Carbapenem-resistant Pseudomonas aeruginosa (CRPA)

What is carbapenem-resistant Pseudomonas aeruginosa (CRPA)?

Pseudomonas infection is caused by strains of bacteria found widely in the environment. The most common type causing infections in humans is called Pseudomonas aeruginosa. Carbapenems are a class of antibiotics that were developed to treat bacteria that are resistant to other drugs. Because of the overuse of these antibiotics, some types of Pseudomonas have developed resistance to carbapenems, and these bacteria are called carbapenem-resistant Pseudomonas aeruginosa (CRPA).

Who gets CRPA?

Healthy people usually do not get CRPA infections. In healthcare, CRPA infections might occur in patients being treated for other conditions. High-risk patients for CRE infections have devices like breathing tubes or bladder and blood catheters. Also at risk are patients on long courses of certain antibiotics.

How are CRPA spread?

CRPA can spread through direct contact with an infected person. It can also spread through contaminated items, like medical equipment, and surfaces, like bed rails and doorknobs.

What does colonization mean?

Colonization means that people carry the bug but are not having any symptoms. People who carry CPRA may not realize it and can pass the germ to another person at risk. A person might be colonized for a long time before getting sick or might never get sick. So, healthcare providers should know the colonization status. They might take steps to prevent infection.

What are the symptoms of CRPA?

Pseudomonas can cause many infections. These include infections of the stomach, lungs, wounds, or blood. CRPA causes the same infections, but the infections are much harder to treat.

How soon after exposure do symptoms appear?

It is not well known how soon symptoms appear after exposure to CRPA. In most situations, exposure to CRPA does not lead to illness. The person might carry the CRPA in his or her body, but not get sick at all, or might get sick from the CRPA days or weeks later.

How are CRPA diagnosed?

We need special lab tests to identify bacteria that cause infections. They will also find which antibiotics, if any, can treat them.

What is the treatment for CRPA?

Treatment options depend on the type of CRPA infection. Some CRPA infections can be treated. But the bacteria must not be resistant to all antibiotics. If you have CRPA, your physician will work with you to figure out the best course of treatment.

What can be done to prevent the spread of CRPA?

Good infection prevention practices can limit the spread of CRPA in healthcare settings. These include wearing a gown and gloves when caring for patients with CRPA, and frequent hand hygiene by healthcare workers. Patients with CRPA should follow their care providers' instructions. They should also keep their hands clean, especially after touching the affected area or using the bathroom. Visitors to a CRPA patient should follow the hospital's precautions.

What if I have CRPA?

Notify all your healthcare providers. Bring this paper if you need help remembering the name of the germ.

Follow your healthcare provider’s instructions. If your provider prescribes you antibiotics, take them exactly as directed. Follow any other medical or hygiene advice your provider gives you.

Wash your hands with soap and warm water. Wash your hands when:

• Eating or preparing food.
• Before and after changing a wound dressing.
• After using the bathroom.
• After blowing your nose, coughing, or sneezing.

Use alcohol-based hand sanitizer when soap and water are not available. Ask and remind healthcare personnel to wash their hands.

What if I am caring for someone with CRPA at home?

Family members who are healthy have a low chance of CRPA infection. CRPA mainly affects people with many medical problems. It is a problem for those who have spent a lot of time in healthcare settings.

Family or caregivers of patients with CRPA must wash their hands before and after touching the patient or medical devices. Handwashing is crucial if the caregiver cares for many sick people at home. Use gloves if contact with body fluids or blood is possible. Family and caregivers should ask and remind others to wash their hands.

How can I get more information about CRPA?

• If you have concerns about CRPA, contact your healthcare provider.
• Call your local health department. You can find your local health department at vdh.virginia.gov/health-department-locator/.
• Visit the Virginia Department of Health website at vdh.virginia.gov/haiar/cro/.
• Visit the CDC website at cdc.gov/pseudomonas-aeruginosa/about/.