Dear friends. Please let me know how many of you have heard of Carbapenemase Producing Enterobacteriaceae ( CPE for short ) without resorting to Google. I would like to know especially from our Sri Lankan friends whether they have heard of anybody infected with this bacteria in Sri Lanka. The reason is …I was supposed to have a Facet Joint injection for my backache this Thursday. In the pre-op assessment, I had to fill a form and it asked if I have been admitted to hospital in the last 18 months and if so where. So I had to answer in the affirmative as I was admitted to Nawaloka Hospital for two days on New Year’s Eve with severe backache and difficulty walking. Apparently, SL is one of the countries where this bacteria is prevalent and I have to have 3 negative rectal swabs before the injection can be given in case I am infected with this. I told the hospital that I have never heard of it and felt it was a waste of time and a money-making routine as it is a private hospital. So I would be grateful if you could let me know if you have heard of this bacteria. Thank you.
Praxy
News, Views and More from Batch'64, Faculty of Medicine, Colombo, SriLanka 
Never heard!
Narme
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Thanks Narme. I appreciate letting me know. Praxy
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Not a sausage Praxy!
My foot! Yet another money grabbing excuse!
Carbapenemarse or not, hope everything will workout well for you.
Ariya
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Thanks Ariya .. I appreciate it.Praxy
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Never heard Praxy
RA
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Thanks Ranjit. Your reply is much appreciated.
Praxy
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Thanks Ranjit for letting me know. I need to know from as many as possible so that I can let them know that doctors on SL haven’t even heard of it. Praxy
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Carbenpamesa or not, my dear Praxy
Looks like a ploy to suck our blood slowly
Private sector in the UK seems no different
Case of stealing your dosh cleverly & surly
Ariya
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Yes Ariya. I am really annoyed about this as driving to this private hospital causes me more backache and for something am 100% sure will be negative. Surely if it was prevalent in SL our clever doctors would have known about it . I can’t believe that they said, if I had this infection I have caught from Sri Lanka I would contaminate the whole operating theatre as the injection would be given in the op theatre. It is definitely a Monet making ploy ☹️☹️☹️☹️
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Sorry Praxy never heard of it. Hope your facet joint injection will go well. Good luck.
Nisantha
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Thanks Nishantha fir letting me know.I appreciate it. Praxy
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Dear Praxy,
Sorry you are having to undergo this hassle. I have never heard of this myself, but its not to say it does not exist or it is a money grabbing ploy. What we ‘know’ is that ‘we don’t know’ I have learnt not to judge or attribute motives to other’s actions without good evidence.
I will ask Biga and get back to you – he knows most things that I don’t and is really upto date with medical developments.
How is Ranjith?
With best wishes,
CJ
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Dear CJ
Thanks for letting me know that you too are not aware of this . So far no one has heard of it.What I am frustrated about is,that unlike MRSA no body has heard of this and they are taking swabs every other day which I am sure will be negative.
Praxy
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It is a “Super Bug” Resistant to Antibiotics
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Dear Simone
I know what it is as I have read about it now on the internet but what I want to know is without resorting to Google whether you have heard of it. Thanks. Praxy
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It is the most commonly reported organism with antibiotic resistance in Australia..according to CARAlert 255 CPE cases reported in Australia during a six month period in Australia in 2018
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Dear Praxy,
I have not heard about this. I will try to get imformations from Bacteriologist.
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Dear Indragee
Thank you fir your reply. I appreciate it: I am so pleased that so far no one has heard about it and I want to tell them when I visit them that today even the consultants living and operating in the country haven’t heard of it. Praxy
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Dear Praxy,
I do the facetal joint injections in the radiology dept on the CT scan table – not in the Theater.
I dont go anywhere near the “outlet” or “inlet” of the GIT !!!!
😜
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Dear Seelan
Thank you for your reply. I presume it means you have not heard of it at all.
Praxy
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Dear Praxy,
Checked from my son who is a GI surgeon at Kurunegala TH.
This is what he has said.
“No not in SL,usually a gut commensal can infect immunodeficients and on long term treatment”
Hope it will help your case.
Best Regards
Dalpe/Shanti
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Dear Dalpe
Thank you for your reply. I take it that you too have not heard of it. The interesting thing would be to find out when I get the invoice how much they are charging for trying to find sone bacteria supposed to be found in SL that even the consultants in SL have not heard about .
Praxy
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This is a message I received from Justin
Dear Praxy,
CPE’s are at present the most important group of resistant bacteria in advanced countries like Australia, UK, etc,., because they are resistant to the most powerful antibiotics we have. Fortunately for people who get infections with them, some of the less powerful antibiotics may have some activity but if one cannot be found, there is a high chance of a fatality. The reason why you might have been singled out, is that most of the bacteria have been picked up and from India and other Asian countries where antibiotic use is not regulated. If they are in your gut microbiome unknown to you and you need to have antibiotics for example after orthopaedic surgery like thee kind you describe, there is a risk that they could cause a difficult to treat infection. In Australia, there is a high chance you would have the same screening whether you had surgery in the public or the private system.
My best wishes for the surgery and trust it proves effective.
With warm regards to both of you.
Justin
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Dear Jistin
Many thanks for taking the trouble to writer to me through Sam. I appreciate it very much. Reading it helped me a lot since I did wonder why I was being tested for something that was not prevalent in Sri Lanka. Your explanation helped me to understand the importance of the test and thanks once again for your informative reply and for your kind wishes for my forthcoming injection. I too hope it helps.
Praxy
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I will ask one of my ID colleagues at work and let you know. We do test for CPE for patients in my hospital.Will get back to you. I hope ho get this message as for the longest due to my poor computer skills was never able to place a comment which was seen by all. Sam spent a lot of time with me on the phone to get me going!!! All the best Selva
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