Klebsiella : This is another harmless bacteria that lives in your mouth, nose, and gut. But it can also cause conditions such as urinary tract infections. How do they spread? Conditions associated with ESBLs. Symptoms of ESBL infection. Treating an ESBL infection. Prevention and outlook. Read this next. What Is Klebsiella Oxytoca? Medically reviewed by Suzanne Falck, MD. Are Staph Skin Infections on the Rise? Medically reviewed by Cameron White, M.
Pepto-Bismol: What to Know. Medically reviewed by Dena Westphalen, Pharm. You can also visit the following website for more information:. Centers for Disease Control and Prevention www.
Your feedback will help us improve the information we provide to patients and caregivers. We read every comment, but we're not able to respond. If you have questions about your care, contact your healthcare provider. For more resources, visit www. Back to top What is extended spectrum beta-lactamase?
ESBL infections occur more often in people who: Are older Have weakened immune systems Have chronic illnesses, such as cancer and diabetes Have been treated with antibiotics in the past Had a recent surgery Have had repeated or long hospital stays Have open wounds or sores Have tubes or drains in their body Back to top What are the symptoms of an ESBL infection?
The symptoms vary depending on the location and type of infection. This suggests that some antibiotics such as carbapenems with activity against ESBL-E may reduce bacterial load of the organism as has been reported previously for VRE [ 23 ]. It seems very likely that the negative association we observed between environmental contamination and clinical infection is also explained by the same mechanism.
High rates of contamination were found on call bells and over bed tables in keeping with reports that some of the most heavily contaminated surfaces are those closest to the patient bed [ 24 , 25 ]. Our study has both strengths and weaknesses that deserve discussion. Secondly the number of visits for each patient was not uniform. However on multivariate analysis, we found no significant relationship between contamination and any particular patient, indicating that these factors were less predictive than others we investigated.
Thirdly, we did not collect data on possible differences in adherence to standard cleaning protocols between wards. Finally, we did not perform molecular typing to conclusively establish that the environmental isolates and plasmids were identical to those from the patient.
However, the corresponding species and extensive antimicrobial susceptibility profiles were consistent between corresponding patient and environmental isolates without exception. The strengths of the study include the large number of environmental samples; the longitudinal sampling allowing assessment of change in risk of contamination over time ; the assessment of the relative importance of both patient and organism risk factors; the range of relevant risk factors that were investigated and the current lack of published data on factors predisposing to environmental contamination with ESBL-E.
This observation may help explain corresponding differences in transmission rates between the two organisms. Patients receiving carbapenems have reduced contamination rates whereas indwelling urinary catheters increase the likelihood of the hospital environment becoming contaminated with ESBL-E. Further studies are needed to confirm the external validity of our findings. Improved understanding of the important mechanisms by which ESBL-E transmit between patients in the hospital setting will provide an opportunity to develop new strategies to prevent their transmission.
JTF contributed to the concept and design of the study, the statistical analysis and manuscript preparation. JN and EG were involved in obtaining patient consent, collecting specimens and collecting patient data. AT, MD and GNM were involved in processing microbiological samples, susceptibility testing and species identification as well as manuscript review.
SAR contributed to the concept and design, organization and execution of the study, as well as review of the manuscript.
All authors read and approved the final manuscript. None of the authors have any conflict of interest to report. The authors would like to acknowledge Deverick J Anderson for his thoughtful review and feedback on an earlier version of this manuscript. National Center for Biotechnology Information , U. Antimicrob Resist Infect Control. Published online Feb 4. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Joshua T Freeman: zn. Received Oct 18; Accepted Dec This article has been cited by other articles in PMC.
Data collection For each patient admission the following putative risk factors for environmental contamination were collected from the clinical records: age and gender of patient; the use of an indwelling urinary catheter IDC ; the receipt of antibiotics in general as well as the receipt of carbapenem antibiotics specifically; the Chronic Disease Score—Infectious Diseases CDS-ID score [ 14 ]; whether the patient had at least one documented episode of diarrhoea; the specimen site s from which ESBL-E were recovered during their stay; the clinical service caring for the patient and whether or not the patient had clinical infection with ESBL-E.
Environmental sampling Sampling of the environment was carried out in eight areas in the patient room and bathroom. Culture methods After being incubated overnight the nutrient broth samples were recorded to show either growth or no growth, based on the presence of a turbid solution. Statistical analysis Analysis was performed using each patient visit as a data point. Open in a separate window. Figure 1. Table 1 Univariate analysis comparing 26 visits with environmental contamination with the visits without environmental contamination.
Figure 2. Price Estimator. Financial Assistance Patient Financial Counseling. Call Us May 07, Extended-Spectrum Beta-Lactamase-Producing Bacteria Extended-spectrum beta-lactamases are enzymes made by certain kinds of germs bacteria. Who is at risk for ESBL infection? They include: A current or recent stay in a hospital or long-term care facility A current or recent stay in the intensive care unit ICU or neonatal intensive care unit NICU A recent surgery or wound treatment Having a urinary catheter, feeding tube, or other tube placed in the body Older age Having a weak immune system, such as after an organ transplant Having long-term antibiotic treatment or taking antibiotics often Close and prolonged contact with a person who is colonized or sick from an ESBL, such as caring for a friend or relative who has returned home from a hospital.
How do ESBL bacteria spread? 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. ESBL bacteria can enter your body in the following ways: Through the mouth. This happens if you have the germs on your hands and then touch your mouth, such as when you eat.
The germs are then swallowed and live in your intestine. Through the urinary tract. This occurs if you already have ESBL in your bowel and don't cleanse properly after a bowel movement. ESBL bacteria can also enter the urinary tract through a urinary catheter, if you have one.
Through a wound or IV site. Through the airway. This happens if the person with the ESBL bacteria coughs or sneezes on you, or if you are on a breathing machine, called a ventilator, and have other risk factors for the germs.
What are the symptoms of ESBL infection? Common places and symptoms include: Urinary tract. How are ESBL bacterial infections diagnosed? How is ESBL bacterial colonization treated? How is ESBL infection treated? This is the single most important way to help prevent the spread of germs. Healthcare workers wash their hands with soap and water or use an alcohol-based hand cleanser before and after treating each person. They also clean their hands after touching any surface that may be contaminated with germs.
Protective clothing. Healthcare workers and visitors will likely wear gloves and a gown when entering the room of a person with ESBL. Before leaving the room, they remove these items and clean their hands.
Private rooms. People with ESBL are put in private rooms.
0コメント