Extended-Spectrum Beta-Lactamase-Producing Bacteria

ESBL are chemicals made by certain kinds of germs (bacteria). These germs break down several types of antibiotic medicine. So when you get sick because of ESBL, the infection is harder to treat and you may need different antibiotics. There are two different ways ESBL can appear in the body:

  • Colonization: When a person carries ESBL bacteria but is healthy. This person can spread ESBL to others.

  • Infection: When a person gets sick because of the bacteria, it's called being infected with an ESBL bacteria. This person can also spread ESBL to others. If not treated properly, ESBL infections can be very serious.

What are the symptoms of ESBL infection?

ESBL causes different symptoms, depending on where the infection is. Common places and symptoms include:

  • Urinary tract: pain and burning when urinating, the need to urinate more often, fever

  • Intestine: diarrhea (may be bloody), pain in the belly (abdomen), stomach cramps, gas, fever, loss of appetite

  • Skin wound: redness of the skin around the wound and oozing of fluid from the wound

  • Blood: high fever, chills, nausea and vomiting, shortness of breath, confusion

Who’s at risk?

Healthy people usually are not colonized or infected with ESBL. But certain things can make colonization or infection more likely. These are called risk factors. They include:

  • Current or recent care at a healthcare facility

  • A recent surgery or wound treatment

  • Using antibiotics for a long period of time

  • Having a weakened immune system

  • Having a medical device that stays in the body for a time, such as urinary or intravenous (IV) catheters

How does ESBL spread?

Ways that ESBL can spread include:

  • Someone who is colonized or infected with ESBL touches you with unwashed hands.

  • You touch objects or surfaces that have the germs.

  • Healthcare workers touch you without washing their hands properly after contact with an infected person, object, or surface.

How is ESBL infection treated?

Because ESBL germs are resistant to many kinds of antibiotics, your care team will tell you how you’ll be treated. Most likely you will take a combination of several antibiotics.

Controlling and preventing ESBL: In the hospital

Hospitals and nursing homes control and prevent ESBL by doing the following:

  • Handwashing. This is the single most important way to prevent the spread of germs.

  • Protective clothing. Health care workers and visitors may wear gloves and a gown when entering the room of a patient with ESBL. They remove these items before leaving.

  • Private rooms. Patients with ESBL infections are placed in private rooms or in a room with others who have the same infection.

  • Avoid antibiotic overuse. Too much use can cause germs to resist some antibiotics.

  • Monitoring. Hospitals monitor the spread of ESBL and educate all staff on the best ways to prevent it.

What you can do as a patient

  • Ask all hospital staff to wash their hands before touching you. Don’t be afraid to speak up!

  • Wash your own hands often with soap and warm water, or use an alcohol-based hand gel. This is especially important:

    • After using the bathroom

    • After touching a bandage

    • Before eating

  • Encourage family and friends to wash their hands as well

  • If you need to have a test done, such as an X-ray, follow instructions from staff. You may need to change into a clean hospital gown and wash your hands just before leaving your room

Controlling and preventing ESBL: at Home


  • Wash your hands often with soap and warm water, or use an alcohol-based hand gel. This is especially important:

    • After using the bathroom

    • After touching a bandage

    • Before eating

  • Follow instructions we give you for caring for surgical wounds or any tubes that you have, such as a catheter or dialysis port.

  • Keep cuts and scrapes clean and covered until they heal.

  • Do not share towels, razors, clothing or athletic equipment.

  • Take all antibiotics your doctor prescribed. Don’t take half doses or stop the antibiotics, even if you feel better.


  • Wash your hands well with soap and warm water before and after any contact with the patient. You can use an alcohol-based hand gel if your hands aren’t visibly dirty.

  • Wear disposable gloves when changing a bandage, touching an infected wound or handling dirty laundry. Throw away the gloves after each use. Then wash your hands well.

  • Change the patient’s bedding once a week, or more often if it’s soiled with feces or body fluids. Wash and dry it alone in a washer and dryer using the warmest temperatures recommended on the labels. Use liquid bleach during the wash cycle if the label permits.

  • Clean surfaces like tabletops and sinks really well. Keep bathrooms, toilets and bedside commodes clean. A mixture of 1/4 cup of bleach to 1 quart of water works great for this.

Understanding drug resistance

Hard-to-kill (resistant) germs, such as ESBL, develop when antibiotics are taken longer than needed. They can also develop when antibiotics are taken when they aren't needed, or are not taken exactly as directed. This is because any germs that survive treatment with an antibiotic can multiply and thus create more resistant germs. The more often antibiotics are used, the more chances resistant germs have to develop. This is why your care team may not prescribe antibiotics unless he or she is certain that they are needed.

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© 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information has been modified by your health care provider with permission from the publisher.