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What is an ESBL?

ESBL means Extended Spectrum Beta-Lactamase producing organism.

ESBL enzymes are normally produced by micro-organisms in the bowel, such as E. coli and Klebsiella. The enzymes break down antibiotics (making them ineffective), and subsequently infections become more difficult to treat.

These bacteria are spread from person-to-person both directly by faecal contamination of the hands and indirectly by the surrounding environment.

 

Illness

E. coli and Klebsiella are common bacteria causing infection in humans, usually chest wound and urinary tract infections (UTIs). These can progress to cause more serious infections in the blood. ESBL-producing strains of the infection are more difficult to treat due to their antibiotic resistance.

Sometimes people can carry ESBL bacteria in the body without showing any symptoms. This is referred to as ‘colonisation’ and although they will not make you ill, good hand hygiene should always be carried out.

 

Treatment

Whilst ESBLs are resistant to a number of antibiotics, there are still antibiotics available should a person show symptoms of clinical infection and this would be discussed with you.

 

Exclusion

As ESBLs are resistant to a number of antibiotics, patients identified to have either an infection or are colonised with these organisms should be managed in a single room for the course of their treatment. However, this is dependent upon the healthcare setting. The ward staff would discuss this with you. If you have a urinary catheter in place it may be removed or replaced by a new catheter to reduce the amount of bacteria present.

 

Prevention

Prudent use of antibiotics is always helpful in reducing resistance developing in bacteria. Antibiotics will be prescribed using the Trust’s Antibiotic Guidelines. This will be discussed with you.

ESBLs are spread from person to person by direct contact with an infected patient and also when hands are soiled after using the toilet and the bacteria is introduced into the mouth via the soiled hands. The bacterium therefore may have come from another patient who had the infection or the environment.

Standard infection control precautions will always be followed, paying particular attention to hand decontamination before and after contact with patients, and also the wearing of gloves and aprons if required. The nurse will discuss this with you.

Visitors and patients should be encouraged to practice good hand hygiene using the hand sanitiser at the point of care and /or hand washing with soap. Unless your family or visitors are already involved in your personal care they do not need to wear gloves or aprons.

Thorough cleaning should also be undertaken to maintain a clean and safe environment. If you feel this is not being done please report this to the nurse in charge of the ward.

Do not visit other patients elsewhere in the ward or hospital.

 

On Discharge

As discussed ESBLs are treated with specific antibiotics and you will be discharged when your general condition allows. When you are home daily personal hygiene and good hand hygiene practices will reduce the spread of the bacteria. Your family are not at risk.

 

Further Information

If you require further information or advice, please ask the Sister or Senior Nurse in charge of the ward.

Further information can also be obtained from the Infection Control Team on 01932 722128 / 723052.

Additional information can be obtained by logging onto: www.hpa.org.uk/Topics/TopicsAZ/.