Pathogens
ESBL Organisms

ESBL Organisms

Precautions

Standard Precautions

Susceptibilities

General Information

Gram negative organisms with enzymes that confer resistance to 3rd generation cephalosporins in addition to lower order beta-lactams.

  • Generally, normal GI flora that have a plasmid encoding ESBL.

  • Community-acquired and nosocomial infections occur, especially if patient has received antimicrobials or has traveled to areas of high prevalence (i.e. Asia/India).

  • Human-to-human transmission occurs and outbreaks have been described.

  • Can also pick up from environment/water, surfaces, animals, and meat.

  • Asymptomatic colonization
  • Any syndrome caused by the organism carrying it (see specific organism for more information)

ESBLs vs. AmpC: Most ESBLs are plasmid-encoded, whereas AmpCs are usually inducible and chromosomal.

In the lab, ESBLs test susceptible to cefoxitin and cefotetan, and are inhibited by beta-lactamase inhibitors such as tazobactam. They test resistant to aztreonam.

Some organizations may place ESBL into contact precautions. (not SAH)