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<p>Public Health England (PHE) has predicted future spread and the health and cost
impact to the National Health Service of the Enterobacteriaceae Escherichia coli and
a national outbreak of a highly-resistant organism, reflecting carbapenem-resistant
Enterobacteriaceae. The models used in this assessment are published in the paper
<em>A Risk Assessment of Antibiotic Pan-Drug-Resistance in the UK: Bayesian Analysis
of an Expert Elicitation Study</em>. A copy of the paper is attached.</p><p>Such predictions
are highly uncertain. There remain unknowns regarding transmission, efficacy of interventions
and the additional hospital stay for infected patients (constituting a large part
of the cost to the NHS).</p><p>PHE has worked with NHS colleagues, estimating the
cost of controlling a carbapenemase-producing Enterobacteriaceae (CPE) outbreak in
five London hospitals to be over £1 million. Monitoring costs alongside implementation
of PHE’s upcoming update of the CPE toolkit for health and social care is an important
component of enabling cost-effectiveness evaluation.</p><p>Staff interviewed about
the challenges of implementing the existing CPE toolkit highlighted maintaining awareness
and training as key challenges, alongside infection prevention resourcing. An analysis
of the responses was published in the paper <em>An evaluation of a toolkit for the
early detection, management, and control of carbapenemase-producing Enterobacteriaceae:
a survey of acute hospital trusts in England</em>. A copy is attached.</p>
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