ESBL Clearing Protocols

The emergence of extended-spectrum beta-lactamase, or ESBL, causes problems in hospitals and long-term care facilities, as these germs develop resistance to antibiotics. Patients with ESBL-producing bacteria develop urinary tract and intestinal infections and on occasion problems with wounds. Due to the bacteria's resistance to some antibiotics and the reluctance to treat it with other antibiotics for fear of developing further resistance, treatment options remain limited. Facility cleaning protocols must be the treatment .

Identification of Risk Factors

• According to an article in the Infectious Disease Control Journal detailing a study of patients in an intensive care unit (ICU), the conclusion identified certain risk factors, such as being over 60 years of age or recent antibiotic use, involved in ESBL-producing bacteria. The study concludes that screening patients upon admission to ICUs for ESBL risk factors should be a standard protocol. Once identified, if those patients exhibit any of the symptoms of ESBL, then they should be treated for ESBL-producing bacteria without waiting for a diagnosis.

Isolation

• According to Mount Nittany Medical Center, hospitals respond to the threat of ESBL-producing bacteria by isolating patients who have ESBL in their rooms as much as possible. This protocol, which includes strict controls over items entering the room and over visitors, meets the criteria of limiting the spread of the bacteria as an integral part of cleaning the hospital.

Prevention

• After treating potential infected patients and isolating those who are infected, the next protocol dictates preventing ESBL-producing bacteria. Good hand-washing techniques continue to be emphasized in hospitals and other facilities, but according to the article in John Hopkins Medicine, that will not be enough to prevent ESBL. Implementation of good practices by hospital staff along with screening of all incoming patients demonstrate good potential as preventive measures.