Extended-Spectrum Beta-lactamase (ESBL) – are chemicals which are produced by a certain type of bacteria. The bacteria break down antibiotics, thereby making infections very hard to treat. Most people are infected by the bacteria in hospitals, and this is due tom improper handing by medical staff. The bacteria can enter the body through the mouth, the urinary tract and any open wounds. It is possible for someone to carry these germs without being affected. Such a person is said to have been “colonized” by the bacteria. A colonized individual can pass the infection to other people even if he or she is not affected. The infections caused by these bacteria need to be treated with a matter of urgency since they can become fatal. This serious condition has forced hospitals to review their hygiene standards in order to protect the patients that they attend to.
ESBL in Urine – The Risk Factors
It is very difficult for a healthy person to be colonized or infected by ESBL bacteria. These infect and colonize people who have a depressed immune system probably due to illness.
1) People who stay for extended stays in hospital have the highest probability of getting infected.
2) People who are an intensive care unit (ICU) for long or a neonatal intensive care unit (NICU) also have a high probability of getting infected.
3) People who have undergone recent surgery or have an open wound
4) People who have catheters and other tubes inserted into their bodies.
5) People who are advanced in age
6) A premature baby
7) People who have had organ transplants, since this cause the immune system to be depressed.
8) People who have been on antibiotics for a long time.
What Are the Symptoms of ESBL Infection?
Depending on the location of the infection, an ESBL infection will present several different symptoms.
If the bacteria enter through the urinary tract, there will be a lot of pain especially when one urinates. The patient will also have the urge to “go” several times, and there may be a fever.
If the bacteria entered through the mouth, the patient will experience diarrhea, which will have blood traces, pain and cramping in the abdomen, a lot of gas production, loss of appetite and a high fever.
If the bacteria entered through a wound, there will be extra inflammation of the wound and it will turn angry-red in color. There will be a lot of fluid oozing from the wound.
If the bacteria entered via the blood, then the patient will get a high fever followed by chills. There will be a lot of nausea and vomiting. The patient may seem confused and will experience shortness of breath.
What is the diagnosis for ESBL?
The patient will have to submit a stool or urine sample depending on the type of infection. The doctor will also take a swab of the infected tissue, in the case of infection via a wound. The lab will test the sample for ESBL.
ESBL in Urine – Treatment and Precautions
A person who has been colonized by the ESBL is not treated, since there is no effective treatment that will kill the bacteria. Treating such a case will encourage the bacteria to become more resistant to antibiotic drugs. Sometimes, when a colonized person experiences an increase in the immune system, the body gets rid of the germs on its own.
A person who has been infected by the ESBL requires a combination of drugs in order to get rid of the ESBL. These bacteria are resistant to a number of antibiotics and only a cocktail of drugs will help eliminate them from your body. Most E.coli that produce ESBL are resistant to tetracyline, fluroquinolones, trimethoprim,cephalosporins, penicillins and other antibiotics. This means, there are only a couple of medications, in the category of oral treatment that can bring down ESBL levels in urine; these are fosfomycin and nitrofurantoin. There are a few intravenous antibiotics that can help as well. The moot thing is to diagnose and find out if the bacteria are resistant to particular antibiotics and then decide on a method of treatment.
In order to control ESBL, hospitals have upped their hygiene and safety standards. Health workers are now washing their hands, or using alcohol-based hand cleansers to clean their hands before and after handling a patient. The same case occurs when they touch surfaces that may have ESBL. When entering a room that has a patient with ESBL, all personnel including visitors are supposed to wear protective clothing and gloves. They will then remove the clothing and wash their hands when leaving the room. Patients with ESBL are booked into private rooms where they cannot accidentally pass the bacteria to other patients. The medical staff also assigns these patients certain medical instruments, which are not shared with others, except when necessary and they have to be sterilized before being used. The hospitals conduct ongoing training to the staff on the methods through which they can contain the spread of ESBL.
On your part, whenever you go to hospital, you can always politely ask any medical personnel to wash their hands before they touch you. It is your right to make such a request. You should also wash your own hands with soap and warm water, or get an alcohol-based hand cleanser.