Pathogens
ESBL Organisms

ESBL Organisms

Susceptibilities

General Information

Meropenem or ertapenem

  • Nitrofurantoin (uncomplicated Cystitis)
  • Fosfomycin (uncomplicated Cystitis)
  • Aminoglycosides

If confirmed susceptible:

  • Cefepime (cystitis)
  • Piperacillin-tazobactam (cystitis)
    • Continue empiric therapy if clinical improvement occurs, don't start based only on sensitivity
  • TMP/SMX (for oral step-down)
  • Ciprofloxacin (for oral step-down)

Gram negative rods

  • Normal GI flora that have a plasmid encoding ESBL

  • Infections commonly nosocomial, but may be community-acquired, especially in patients with recent antimicrobial exposure

  • Can also be acquired from environment/water, surfaces, animals, and meat

See individual organisms

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

  • In the lab, ESBLs test susceptible to cefoxitin and may be inhibited by beta-lactamase inhibitors in vitro