CPE Research Plan

CPE Research Plan

Research plan for effective surveillance and control of carbapenemase-producing Enterobacteriaceae

Introduction to the project

In April 2017, a carbapenemase-producing Enterobacteriaceae (CPE) research plan was finalized by a consortium of Dutch research partners, coordinated by Immuno Valley, and commissioned by the Ministry of Economic Affairs.

Carbapenemase-producing Enterobacteriaceae (CPE)

CPE are Gram-negative bacteria that are resistant to the carbapenem class of antibiotics. Carbapenems are last-resort antibiotics in human medicine used to treat infections caused by multi-drug-resistant organisms. Resistance against these carbapenems is a very serious threat since little treatment options are available for people and/or animals infected with CPE.

Fortunately, until now, carbapenemase-producing isolates have only incidentally been reported in health care settings in the Netherlands. Enterobacteriaceae with plasmid-mediated carbapenemase genes have never been reported in companion animals, livestock or livestock-derived consumer products in the Netherlands.

Currently, information on CPE colonization, epidemiology and transmission in livestock and companion animals is very limited. This makes it difficult for risk managers to design strategies to deal with a possible CPE introduction and/or manifestation (CPE episode) in these animals. Therefore, the Ministry of Economic Affairs asked Immuno Valley to build a consortium of experts, that together were able to write a CPE research plan.

Project aim

As consortium coordinator, Immuno Valley managed to build a consortium of academic experts, within the field of diagnostics, epidemiology, microbiology, surveillance and clinical research. In addition, experts affiliated to stakeholder organizations, having a legal task in public health maintenance in the Netherlands, are part of the consortium. The experts described the research activities that they estimated to be crucial to fulfill the research aim: to gain more knowledge on the sources and mechanisms of CPE colonization, transmission and spread of CPE. The proposed research is categorized in three phases: research to be performed before a CPE episode takes place, research to be performed during a CPE episode and after an episode.

The CPE research plan was presented to the Ministry of Economic Affairs in April of this year, after which this was discussed with stakeholders from the Netherlands. Since antibiotic resistant bacteria are able to cross borders, the battle against these threats request an international approach. Therefore, the CPE research plan will also be subject of a meeting with the European Commission, as can be read in the letter to Dutch Parliament. (from 12 July 2017)

Project partners

The consortium, led by Professor Arjan Stegeman, veterinary epidemiologist at Utrecht University, consists of partners from the Dutch National Institute for Public Health and the Environment (RIVM), the Faculty of Veterinary Medicine at Utrecht University, GD Animal Health, Immuno Valley, Netherlands Food and Consumer Product Safety Authority (NVWA), Public Health service (GGD), UMC Utrecht, Wageningen Bioveterinary Research, and was supported by the Ministry of Economic Affairs.