Carbapenemase-Producing Organisms (CPO)

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Page last updated  5/27/2026.

Prevention

Patients and Caregivers:

• Keep your hands clean, particularly before and after caring for wounds or touching a medical device.
• Remind people (including healthcare providers) to clean their hands before touching the patient or handling medical devices.
• Allow healthcare staff to clean the room daily when in a healthcare setting.
• Take medication as prescribed by your healthcare provider.
• Follow patient safety tips in healthcare settings.

For Healthcare Facilities and Infection Preventionists:

• Follow standard hand hygiene practices.
• Use Contact Precautions or Enhanced Barrier Precautions (EBP) based on the facility/setting. 
• Follow the recommended Public Health general cohort guidance and Skilled Nursing Facility cohort guidance as applicable.
• Regularly and thoroughly clean and disinfect the patient care environment and equipment with an EPA List P disinfectant with 5 minutes or less contact time.
• Use an interfacility transfer communication tool when transferring a patient between healthcare facilities to communicate MDRO history.  
• Sustain good facility maintenance practices, repairs, and a robust water management program.
• Implement a policy to screen targeted organisms in high-risk facilities.
• Laboratory surveillance.

Public Health Guidance

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Transmission

Transmission can occur from contact with the infected patient or contaminated surfaces and equipment.

• Patients with CPO often unknowingly transfer it onto surfaces and objects in healthcare settings like bedrails, doorknobs, and blood pressure cuffs.
• CPO can survive on surfaces and objects for a long time and spread to other patients who can then become sick.
• CPO can remain on a patient's skin or body for a long time, whether or not they show symptoms. During this time, a patient may continue to spread CPO.

Healthcare workers often use personal protective equipment (e.g. gowns and gloves) when caring for patients with CPO.

Who is at risk?

Patients in healthcare settings are at most risk for CPO, especially those who:

• Require medical devices like breathing machines, bladder catheters, or vein catheters.
• Are taking long courses of certain antifungals.
• Wounds requiring treatments.
• Have weakened immune systems.

Medical devices such as those listed above are often necessary but create pathways for CPO to get into the body.

Who is not at risk?

People who do not have these risk factors generally do not carry or become sick from CPO. This includes healthcare providers and visitors. Most of the time, it is unnecessary to screen or test healthcare providers and family members.

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Symptoms

CPO symptoms can vary depending on the site of the infection (e.g., blood, urinary tract, lungs (pneumonia), wounds, or other parts of the body).

In some cases, people can carry these bacteria without having an infection, this is known as colonization. Colonization means that the organisms are found in or on the body, but it is not causing any symptoms.  CPOs can colonize many body sites, including skin, respiratory tract, wounds, and digestive tract. Patients can remain colonized for several weeks, months or longer even if they never show symptoms.

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Diagnosis and Treatment

CPO is diagnosed through laboratory testing. This can occur through screening to identify those who are colonized or through cultures. The provider will determine the right testing for the patient.

If someone has an infection, the provider should decide the right antibiotic treatment. Some CPO infections are resistant to multiple antibiotics and it may be necessary to consult with an infection disease specialist.

If someone is colonized, treatment is usually not recommended. Knowing if you are colonized can help the healthcare providers know how to treat an infection if one occurs and prevent spread to others.

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Resources

County of San Diego

California Department of Public Health (CDPH)

• CPO Information for Patients and Families​
• CPO Quicksheet and Phases

Centers for Disease Control and Prevention (CDC)

• Antimicrobial Resistance Laboratory Network Data Explorer
• Pseudomonas aeruginosa | P. aeruginosa
• Carbapenem-resistant Enterobacterales (CRE) | CRE | CDC

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Contact the San Diego Healthcare-Associated Infections Program through our contact form, via e-mail, or call the Epidemiology Unit at (619) 692-8499.