Introduction
Extended Spectrum Beta-Lactamases (ESBLs) are enzymes produced by bacteria such as Escherichia coli (E.coli) and Klebsiella.
These are mainly bacteria that are found normally in the human bowel, but can cause serious illness. ESBLs can be resistance to a range of frequently used antibiotics including penicillin’s and cephalosporins
As a result, infections caused by these bacteria can be difficult to treat and the prevalence of these bacteria and infections caused by them are becoming more common in both community and healthcare settings.
What illnesses do ESBL producing bacteria cause?
The most common bacteria that produce these enzymes are E. coli and Klebsiella which are bacteria that can live in your bowel without you being unwell or showing any signs or symptoms of infection (this is referred to as colonisation).
These bacteria cause infection if they get into an area of the body where they are not normally found, such as the urinary tract. Urine infection is the most commonly diagnosed infection, but infection in the lungs (chest), wounds and in the blood can also occur. Infections caused by ESBL-producing bacteria can be more difficult to treat because of antibiotic resistance, as there are fewer effective antibiotics to use.
Can illnesses caused by ESBL producing bacteria be treated?
Yes, despite being resistant to many antibiotics, there are still antibiotics available to treat infections should they occur. Your doctor will discuss your antibiotic treatment options with you. Antibiotic treatment is not generally recommended for people who are colonised and who do not have signs or symptoms of infection.
How can ESBL producing bacteria be spread?
As with other bacteria, ESBL-producing bacteria can be spread from person-to-person on unwashed hands, on equipment that is contaminated and has not been sufficiently cleaned, or can be picked up from the environment. This can happen both in the community and in hospital.
Who is at risk?
There are a number of factors that make a person more likely to become colonised or infected with ESBL-producing bacteria. These include: having an underlying illness that makes a patient more susceptible to infection, taking repeated courses of antibiotics a prolonged stay in hospital and having a urinary catheter.
What happens if I am found to be colonised or infected with ESBL producing bacteria?
If you are found to be colonised or infected with ESBL-producing bacteria you may be transferred to a single room. This is to minimise the risk to other patients on the ward who may be more vulnerable to the risk of infection.
Healthcare staff will also take extra precautions to prevent the spread of infection to other patients, for example they may use disposable gloves and aprons.
Staff members do not mind if you remind them to clean their hands.
Make sure you wash your hands after using the toilet and before you eat.
Try not to touch wounds, catheters and other devices like drips.
If I am found to be colonised or infected with ESBL producing bacteria, how long do I have to stay in a single room?
This will vary from patient to patient. If you have symptoms or signs of infection or have an indwelling catheter or diarrhoea you will usually remain in a single room for the duration of your hospital stay. It is not known how long colonisation with ESBL-producing bacteria persists but in most circumstances it is not necessary to re-test or swab you to check whether these bacteria are still present
Can I have visitors?
The risk to visitors and relatives is low if they are fit and well. If they have been unwell in the last 48 hours please ask them not to visit until they are feeling better.
Prevention of infection rests mainly on good hand hygiene for you and your visitors. This includes cleaning hands before entering and leaving the ward and before helping you to eat and drink.
Will I have to stay in hospital longer?
You will not have to stay in hospital until the ESBL infection has cleared. You will be able to go home when your condition allows, regardless of whether you still have ESBL-producing bacteria or not. This should not be a risk to your family or friends.
Normal personal hygiene (baths/showers) is sufficient, as is normal household cleaning. Clothes should be laundered as normal
Further general information can be found here;
