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The acceptability of screening for Carbapenemase Producing Enterobacteriaceae (CPE): cross-sectional survey of nursing staff and the general publics’ perceptions

Currie, Kay; King, Caroline; McAloney-Kocaman, Kareena; Roberts, Nicola J.; MacDonald, Jennifer; Dickson, Adele; Cairns, Shona; Khanna, Nitish; Flowers, Paul; Reilly, Jacqui; Price, Lesley


Kay Currie

Caroline King

Kareena McAloney-Kocaman

Jennifer MacDonald

Adele Dickson

Shona Cairns

Nitish Khanna

Paul Flowers

Jacqui Reilly

Lesley Price


Carbapenemase Producing Enterobacteriaceae (CPE) has spread rapidly and presents a growing challenge in antimicrobial resistance (AMR) management internationally. Screening for CPE may involve a rectal swab, there are limited treatment options for affected patients, and colonised patients are cared for in isolation to protect others. These measures are sound infection prevention precautions; however, the acceptability of CPE screening and its consequences are currently unknown.

The aim of this study was ‘To determine factors influencing acceptability of CPE screening from the perspectives of nursing staff and the general public.’

National cross-sectional surveys of nursing staff (n = 450) and the general public (n = 261). The Theoretical Domains Framework (TDF) guided data collection and analysis. Regression modelling was used to identify factors that predicted acceptability of CPE screening.

For nursing staff, the following predictor variables were significant: intention to conduct CPE screening (OR 14.19, CI 5.14–39.22); belief in the severity of the consequences of CPE (OR 7.13, CI 3.26–15.60); knowledge of hospital policy for screening (OR 3.04, CI 1.45–6.34); preference to ask patients to take their own rectal swab (OR 2.89, CI 1.39–6.0); awareness that CPE is an organism of growing concern (OR 2.44, CI 1.22–4.88). The following predictor variables were significant for the general public: lack of knowledge of AMR (β − .11, p = .01); social influences (β .14, p = .032); social norms (β .21p = .00); acceptability of being isolated if colonised (β .22, p = .000), beliefs about the acceptability of rectal swabbing (β .15, p = .00), beliefs about the impact of careful explanation about CPE screening from a health professional (β .32, p = .00).

Integrating results from staff and public perspectives points to the importance of knowledge of AMR, environmental resources, and social influences in shaping acceptability.

This is the first study to systematically examine the acceptability of CPE screening across nursing staff and the public. The use of TDF enabled identification of the mechanisms of action, or theoretical constructs, likely to be important in understanding and changing CPE related behaviour amongst professionals and public alike.


Currie, K., King, C., McAloney-Kocaman, K., Roberts, N. J., MacDonald, J., Dickson, A., Cairns, S., Khanna, N., Flowers, P., Reilly, J., & Price, L. (2018). The acceptability of screening for Carbapenemase Producing Enterobacteriaceae (CPE): cross-sectional survey of nursing staff and the general publics’ perceptions. Antimicrobial Resistance and Infection Control, 7(1), Article 144.

Journal Article Type Article
Acceptance Date Nov 8, 2018
Online Publication Date Nov 23, 2018
Publication Date 2018
Deposit Date Aug 30, 2022
Publicly Available Date Jun 27, 2023
Journal Antimicrobial Resistance & Infection Control
Print ISSN 2047-2994
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 7
Issue 1
Article Number 144
Keywords CPE screening, Acceptability,, Public perceptions, Staff perceptions, Theoretical domains framework
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