Rapid Molecular Screening Aims to Accelerate Hospital Infection Control for CPE

Drug-resistant infections remain a critical patient-safety threat in hospitals, with carbapenemase-producing Enterobacterales (CPE) among the most urgent concerns. In England, reports of acquired carbapenemase producers more than doubled between 2021 and 2023, and undetected carriage can trigger outbreaks, longer stays, and higher mortality. A newly launched 30-month real-world study now evaluates whether rapid molecular CPE screening can accelerate infection control decisions and inform National Health Service (NHS) policy.

The TRACE-CPE study is being delivered by the Fleming Initiative, a partnership between Imperial College London and Imperial College Healthcare NHS Trust, in collaboration with Cepheid. Conducted over two and a half years at Imperial College Healthcare NHS Trust and Guy’s and St Thomas’ NHS Foundation Trust, the program will generate evidence to guide the use of rapid antimicrobial resistance (AMR) screening in large, complex acute-care settings. The findings are intended to support hospital operations and inform national screening policy.

Image: The study compares rapid molecular CPE diagnostics, which can return results in about one hour, with culture-based screening, which typically takes about 48 hours (Image credit: Adobe Stock)

The technology under evaluation is rapid molecular CPE screening, which can return results in approximately one hour, compared with around 48 hours for culture-based methods. Investigators will test these diagnostics in frontline NHS workflows to measure effects on clinical practice, infection prevention and control, and hospital transmission. The protocol also includes analysis of patient risk factors and colonization patterns to clarify how CPE spreads within hospitals.

Beyond turnaround time, TRACE-CPE will examine how rapid screening integrates into routine processes and impacts health-system productivity, patient experience, and costs. The study aims to strengthen antimicrobial stewardship (AMS), support delivery of the National Action Plan (NAP), and align with the NHS 10-year plan. By drawing on patient populations representative of high-volume acute care, the project seeks to produce a robust evidence base for decision-makers.

Ultimately, the research is designed to provide policymakers, hospital leaders, and clinicians with practical data on when and how rapid molecular CPE screening should be implemented across the NHS and in comparable health systems facing rising drug resistance.

“Antimicrobial resistance will not be addressed effectively by awareness alone. It will be solved by evidence, translated into practice, in the places where antibiotic decisions are actually made,” said Dr. Jonathan Otter, Director of Infection Prevention and Control at Guy’s and St Thomas’ NHS Foundation Trust and Principal Investigator for TRACE-CPE. “TRACE-CPE is the sort of cross-disciplinary collaboration the Fleming Initiative was created to enable. Our aim is a future where CPE does not spread in our hospitals, and rapid, accurate testing is central to making that future real.”

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Fleming Initiative