12-Year Experience with Rapid PCR for Carbapenemase-Producing Enterobacteriaceae Screening in a Public Hospital in...

France issued recommendations to control the spread of carbapenemase-producing Enterobacteriaceae (CPE) in 2013. We describe our experience with the implementation of national CPE screening guidelines in a French public hospital and its impact on CPE detection. Rapid PCR for CPE screening in our hospital began in 2014. Patients at-risk of CPE carriage are screened upon hospital admission. Rectal swab samples are tested either by PCR seven days/week or culture six days/week. The number of screening-detected CPE carriers increased from 2014 (n = 5) to 2025 (n = 138) and substantially increased in 2017 (n = 20) when primary screening of contact patients by rapid PCR was implemented. In 2022, 1,388 screenings by rapid PCR for 926 patients were performed, 37 of whom were positive, and 1,654 screenings by culture for 1,059 patients were performed, 50 of whom were positive. Screenings and positive results approximately tripled by 2025. There were 1-8 epidemics/year until 2022; each epidemic had 1 to 2 secondary cases. Two epidemics in 2023 were difficult to manage, possibly caused by reduced compliance with CPE procedures. Twelve years of CPE screening with rapid PCR in accordance with French guidelines has allowed Valenciennes hospital to limit CPE epidemics, although compliance by hospital personnel to CPE precautions has proved challenging. Our success at detecting CPE and minimizing epidemics through the implementation of national screening guidelines can serve as a model for other French public hospitals.