Contact Precautions
Gram-negative bacilli with extended spectrum beta-lactamases (“ESBL”), found in the Enterobacterales order.
ESBL plasmids can be found among the normal gastrointestinal flora of healthy individuals. 5 to 15% of Enterobacterales organisms isolated in Ontario hospitals may carry ESBL plasmids.
Global distribution, with higher rates in Asian populations. Risk factors may include:
Direct (human-to-human) and indirect (environment, food, surfaces) transmission can occur.
See individual organisms for associated syndromes.
ESBL vs. AmpC organisms: most ESBL organisms are plasmid-encoded and constitutively expressed, whereas AmpC organisms are usually inducible and chromosomal (although some may become constitutive or transferable to other organisms).