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ESBL (extended-spectrum beta-lactamases)

Pūmua whākōkī whawhai rongoā paturopi

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A beta-lactamase is an enzyme. It's produced by some bacteria (germs) and it prevents certain antibiotics from working.

Bacteria that produce this enzyme are more resistant to many of the antibiotics prescribed to treat infections. This makes an infection caused by ESBL-producing bacteria more difficult to treat and means that only a limited range of antibiotics can be used.

ESBL-producing bacteria are part of a group of bacteria known as multi-drug-resistant organisms (MDRO).

Types of ESBL-producing bacteria include E. coli and Klebsiella, both of which normally live in your bowel without making you sick.

ESBL-producing bacteria aren't usually a risk to healthy people. People in hospital are at risk of infection because their body's defence mechanisms are weakened by illness, surgery, medications and medical procedures.

Effects of ESBL-producing bacteria

You can be colonised or infected by ESBL.

Colonised means that you have the bacteria in your bowel, but you aren't sick because of it and your hospital stay shouldn't be increased.

Infection means that bacteria in or on your body are making you sick. ESBL-producing bacteria can cause infections like gastroenteritis, urinary tract infections and wound infections.

You can become colonised or infected by ESBL-producing bacteria if you touch other people who have the infection or surfaces that are contaminated then touch your mouth area without having washed your hands. ESBL-producing bacteria aren't spread through the air by coughing or sneezing.

Diagnosing ESBL-producing bacteria

If your doctor thinks you may be colonised or infected with ESBL-producing bacteria, they will do some simple tests. This might involve taking a rectal swab or a faecal or urine sample. The results of these tests will help your doctor work out the best form of treatment for you.

Treating ESBL-producing bacteria

There are still a few antibiotics that can be used to treat infections caused by ESBL-producing bacteria. Your doctors will decide which antibiotic will best treat your infection.

Avoiding the spread of ESBL-producing bacteria

In hospital, you can potentially spread the bacteria to other patients.

To reduce the risk of spreading the infection, it's important to have good hand hygiene. This includes washing your hands with soap and water, especially after using the toilet and before eating or drinking. Alcohol-based hand rubs are an excellent alternative to hand washing. They're available in all hospital wards and departments.

If you're in hospital, you may be placed in isolation to reduce the risk of spreading ESBL-producing bacteria to other patients. This means you may be in your own room and have your own toilet.

Hospital staff caring for you may wear gloves and gowns or aprons to prevent them carrying the bacteria to other patients.

If you're in isolation, it's important that you do not visit patients in other parts of the ward or in other wards. You may also be asked not to go into communal areas on the ward.

Encourage everyone, including healthcare workers, to wash their hands after visiting you.

Healthy visitors, including pregnant women and young children, aren't at risk from ESBL-producing bacteria. But your visitors must wash their hands or use alcohol-based hand rub when they leave your room.

If your visitors are going to visit other people in the hospital, they should do that before coming to see you.

Your family can take your laundry home and wash it as usual.

ESBL-producing bacteria will not stop you going home from hospital. You'll be discharged as soon as your general condition allows.

The presence of ESBL-producing bacteria doesn't pose a risk to the health of your family and friends when you're at home or at work.

At home, maintain good personal hygiene and household cleaning. Good hand washing is very important. You can wash towels, clothes, bed sheets and other items as usual. You can also wash utensils and dishes as usual. You do not need to limit activities or visitors to your home.

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Written by Infection Prevention and Control Service, Canterbury DHB. Adapted by HealthInfo clinical advisers. Last reviewed May 2022.

Sources

Page reference: 57597

Review key: HIMDR-85207