Extended-Spectrum Beta-Lactamase (ESBL)-Producing Bacteria

How it Spreads

• Directly through touch if hands are unwashed after exposure to the bacteria. It spreads primarily via unwashed hands of healthcare providers.
• Indirectly by contact with soiled equipment, especially urine-care equipment such as catheters or urinals.
• Indirectly by contact with contaminated environmental surfaces, such as counters, sinks, or doorknobs.

ESBL Colonization and Infection

• Colonization: for most people ESBL does not cause harm and does not cause any symptoms. These people are called carriers and are considered colonized.
• Infection: for the few people who develop an infection, the symptoms are specific to what part of the body is infected. This can include symptoms of urinary tract, wound, pneumonia, or blood infections.
• A rectal swab or stool sample can determine if you are colonized or infected with ESBL. If indicated, a urine specimen can also be collected. 

Risk Factors for Infection and Colonization

• Prolonged and extensive treatments with certain antibiotics.
• Prolonged hospital or intensive care unit (ICU) stay.
• Severe illness, especially neutropenia, organ transplants, those requiring total parenteral nutrition, and neonates.
• Organ transplants.
• Presence of indwelling catheters, especially urinary and arterial/central venous catheters.
• Mechanical ventilation.
• Renal replacement therapy.
• Household contact of a patient with ESBL.
• Those previously colonized or infected with ESBL.
• Those exposed to a facility with an ESBL outbreak. 

Prevention

• Wash your hands thoroughly and often with warm soapy water for at least 15 seconds, especially: 
  • after going to the washroom.
  • after blowing your nose.
  • before eating and drinking or preparing food.
  • before and after caring for someone who is sick.
  • before and after touching any dressings or wounds.
  • if you are a staff or visitor and have contact with a patient or resident in a healthcare facility.
• If you are a resident or patient in a healthcare facility:
  • ensure those providing care to you or visiting are washing their hands prior to contact with you.
  • do not take antibiotics unless it is required and ensure you take them exactly the way they were prescribed.
  • routine cleaning and disinfection of common touch surfaces including faucets, door handles, bedrails, bathrooms, and other surfaces that people touch is important.

Treatment 

• Appropriate use of antibiotics is important to ensure effective treatments are available if the need should arise.
• People who are carriers of ESBL do not require antibiotic treatment since this could lead to increased antibiotic resistance.
• ESBL infections may require antibiotic treatment.