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healthcare-associated infections (hai) program

Carbapenem-resistant Pseudomonas aeruginosa (CRPA)

Pseudomonas aeruginosa are a type of bacteria commonly found in water sources and healthcare environments, and known to cause serious infections in the blood, lungs (pneumonia), or other parts of the body after surgery. 

Frequently Asked Questions

What are CRPA?

Pseudomonas aeruginosa bacteria are particularly likely to become resistant (no longer respond) to several types of antibiotics (multidrug-resistant). Carbapenem-resistant Pseudomonas aeruginosa (CRPA) are resistant to last-resort antibiotics called carbapenems. 

Why are CRPA a problem?

CRPA can spread from patient to patient in healthcare settings like hospitals and nursing homes. There are limited antibiotic treatment options for patients who develop infections caused by CRPA. Patients with CRPA infections have significantly worse outcomes than patients with non-carbapenem-resistant infections.

Who is at risk of getting CRPA?

In general, healthy people are not at risk of CRPA. People who have spent time in healthcare facilities like hospitals or nursing homes are at the highest risk of becoming carriers of CRPA (colonized) and developing infections. Risk factors for CRPA include:
  • Being on a mechanical ventilator (breathing machine)
  • Having indwelling medical devices such as urinary catheters or endotracheal tubes
  • Having wounds from surgery or burns
  • Recent stay at a long-term acute care hospital or a ventilator-equipped skilled nursing facility
  • Recent overnight stay at a healthcare facility outside the United States

How are CRPA spread?

There are different ways CRPA can spread:
  • Direct person-to-person contact through contact with wounds or respiratory secretions
  • Indirect person-to-person contact via the hands or clothing of healthcare providers, or contact with contaminated surfaces or medical equipment

What can patients and families do to prevent CRPA infections?

Patients and families can take several important steps to help prevent drug-resistant infections like CRPA. Make sure to:
  • Tell your doctor if you have ever been diagnosed with a drug-resistant infection, or hospitalized elsewhere, especially outside of the United States.
  • Take antibiotics only as prescribed.
  • Expect all healthcare providers to wash their hands with soap and water or an alcohol-based hand rub before and after touching your body or tubes going into your body.  If they do not, ask them to do so.
  • In many healthcare settings, healthcare personnel will wear gloves and gowns when interacting with patients with CRPA.
If you have CRPA or are caring for someone who does, make sure to clean your own hands and practice good hygiene. This is especially important during the following activities:
  • Before preparing or eating food
  • After using the bathroom
  • Before and after changing wound dressings or bandages
  • After blowing your nose, coughing, or sneezing

Should family members or other close contacts of patients be tested for CRPA?

CDPH does not recommend family members or otherwise healthy close contacts of patients with CRPA infection or colonization be tested for CRPA. In general, healthy people are not at risk of CRPA and do not need to be tested.

What can healthcare facilities and public health departments do to prevent CRPA transmission?

Preventing the spread of CRPA and other antibiotic-resistant bacteria is essential to patient safety and making sure antibiotics continue to work in the future. Healthcare providers and public health practitioners should visit the CDPH webpage for Carbapenem-resistant and Carbapenemase-producing Organisms to learn more about how healthcare facilities and public health departments can prevent transmission of drug-resistant pathogens like CRPA. Local health departments can view the CDPH Carbapenem-Resistant Pseudomonas and Acinetobacter Quicksheet (PDF) when working with facilities to prevent CRPA transmission in their jurisdiction.

Additional CRPA Resources

For additional information contact the HAI Program at HAIProgram@cdph.ca.gov.
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