• Extended Spectrum Beta-Lactamase Infection

    (ESBL)

    Definition

    ESBLs are enzymes that are produced by bacteria. The enzymes make the bacteria resistant to many kinds of antibiotics.
    It is possible to carry these bacteria without being sick. This is called being colonized. A person who is colonized can still spread the infection to others. The bacteria that carry the enzymes can cause serious infections, such as those in the:
    • Intestines
    • Urinary tract
    • Respiratory tract
    If not treated, the condition can be fatal.
    The Intestines
    IMAGE
    The bacteria can travel to the intestines, causing a serious infection.
    Copyright © Nucleus Medical Media, Inc.

    Causes

    This condition occurs when the body is infected with bacteria. These bacteria produce enzymes that make the infection resistant to many kinds of antibiotics. That is why it is so hard to treat.
    These bacteria can be easily spread in close living areas, like hospitals. They are most often spread by:
    • Medical equipment
    • The hands of healthcare workers

    Risk Factors

    Factors that increase your risk of being colonized by or infected with ESBL include:
    • Admission to an intensive care unit (ICU)
    • Recent surgery
    • A long hospital stay
    • Use of invasive medical devices, such as a urinary catheter
    • Antibiotic use
    • Nursing home residence
    • Recurrent urinary tract infections
    • Use of a feeding tube
    • Hemodialysis
    • Diabetes
    • Poor nutrition

    Symptoms

    Symptoms depend on the location of the infection and may include:
    • Fever
    • Pain in abdomen
    • Pain and burning with urination
    • Signs of infection around a wound, such as redness or oozing discharge
    • Diarrhea
    • Loss of appetite
    • Chills
    • Nausea and vomiting
    • Trouble breathing

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. Tests may include:
    • Urine, stool, or blood tests
    • Swab of the rectum or throat
    The bacteria in the samples are then tested to see if it they are resistant to certain antibiotics.

    Treatment

    Talk with your doctor about the best treatment plan for you. There are only a few antibiotics that can be used to treat this infection.
    It is also important to take steps to control the spread of ESBL infections, such as:
    • Preventing the spread of ESBL-producing bacteria to others by isolation, hand washing , and other steps
    • Avoiding unnecessary procedures or unnecessary use of antibiotics

    Prevention

    To help reduce your chance of an ESBL infection:
    • Wash your hands thoroughly, and ask others to wash their hands.
    • Avoid coming into contact with people who have this infection.
    • Make sure healthcare staff and visitors wash their hands before and after touching you or touching contaminated surfaces.
    • Make sure healthcare staff and visitors use gloves.

    RESOURCES

    Centers for Disease Control and Prevention http://www.cdc.gov

    National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    Dhillon RH, Clark J. ESBLs: a clear and present danger? Crit Care Res Pract. 2012;2012:1-11.

    Doi Y, Adams J, O'Keefe Alexandra, Quereshi Z, Ewan L, Paterson DS. Community-acquired extended spectrum beta-lactamase producers, United States. Emerg Infect Dis. 2007;13(7): 1121-1123.

    Extended-spectrum beta-lactamases (ESBLs): Guidance, data, analysis. Public Health England website. Available at: https://www.gov.uk/government/collections/extended-spectrum-beta-lactamases-esbls-guidance-data-analysis. Published July 1, 2014. Accessed June 11, 2015.

    Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev. 2005;18(4):657–686.

    Seigel JD, Rhinehart E, Jackson M. Management of multidrug-resistant organisms in healthcare settings, 2006. Available at: http://www.cdc.gov/hicpac/pdf/guidelines/MDROGuideline2006.pdf. Updated December 29, 2009. Accessed June 11, 2015.

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