Extended-spectrum beta-lactamases, or ESBL, is an enzyme that is produced in some forms of bacteria. The most common forms of bacteria to produce this enzyme are those associated with E. coli and certain strains of pneumonia. Most ESBL producing bacteria belongs to the family of these organisms known in the medical and scientific communities as Enterobacteriaeae. Bacteria that produce ESBL can be found worldwide. ESBL-producing bacteria can be transferred from patient to patient and can also be transferred through hospital staff, instruments and prolonged antibiotic exposure.
Although some strains of bacteria can be good for the body, others produce potentially fatal illnesses. Antibiotics have been developed to combat and rid of the body of the harmful bacteria. However, over time, some bacteria have evolved to become resistant to antibiotics. The bacteria have adapted by creating the enzyme ESBL. This enzyme breaks down antibiotics, making the bacteria resistant to treatment, according to a 2003 report in the British Medical Journal.
Initial treatment for ESBL involves taking an antibiotic. However, if antibiotic treatment proves ineffective, the physician will take samples from the blood or the affected area. The types of screening tests currently available for identifying ESBL enzymes are double disk approximation, combination disk and microdilution.
Once the screening tests indicate ESBL is present, a confirmatory test is done. The types of confirmatory tests include: MIC broth dilution, E test, Automated instruments, and Molecular testing (British Medical Journal, 2003).
Treatment After Testing
Once initial testing has been performed, and the ESBL enzymes are shown to be present, further testing is done on the particular bacteria. This is done by administering multiple rounds of antibiotics in order to determine the correct antibiotic or combination of antibiotics to use to combat the infection. Once the proper antibiotic regimen is discovered, the medicine is used to treat the patient.
Proper use of infection control practices should be used at all times in medical facilities, where the bacteria that produce ESBL are most prevalent. According to the Centers for Disease Control, these practices include proper hand washing by the medical staff and proper sterilization of all medical equipment. Tubes (i.e. catheters, feeding tubes, etc.) should be checked often in order to diagnose an infection earlier. Additionally, education should be provided to all medical staff so that they may have the know-how to identify these types of infections.