ESBL

Please click the frequently asked questions below for further information and IPC precautions required:

• What is Extended spectrum beta lactamase (ESBL) bacteria?

  ESBL stands for Extended Spectrum Beta-Lactamase. Beta-lactamases are enzymes produced by some bacteria that may make them resistant to some antibiotics. ESBL production is associated with a bacteria usually found in the bowel. ESBL bacteria can be

  present in the bowel of individuals without their knowledge and may survive there harmlessly until the person becomes ill or requires antibiotic therapy

  Who is at risk of being infected with an ESBL producing bacteria?

  • Anyone can get an ESBL producing bacteria. Patients in hospital/care homes with open wounds, urinary catheters, drainage tubes and those who are ill are at a higher risk of getting an ESBL bacteria.
  • Anyone receiving a lot of antibiotics, in particular if the course of antibiotics has not been completed for the prescribed period of time, may be at increased risk of getting the bacteria.
  • Anyone who has had contact with a patient/client that already has an ESBL producing bacteria is also at higher risk.

  

• Why is this information important?

  If NIAS staff are aware that the patient has a suspected or confirmed case this should be communicated to the Control Room (Emergency or Non-emergency as appropriate) and the staff in the receiving unit when transferring the patient to ensure effective patient care and management.

• How is it spread?

  An ESBL can spread between patients either through contact with a patient known to have ESBL or by touching the environment that has been occupied by a patient with an ESBL e.g. patient equipment, stretchers, hand rails, straps etc.

  The risk increases if the patient is having diarrhea as the bacteria can live harmlessly in the gut.

  It can also be spread through staff’s hands if staff do not adhere to the 5 moments of Hand Hygiene (HH) using the 7 step technique. It is also essential that staff use PPE appropriately ensuring that gloves are used and changed appropriately with HH.

• IPC Precautions
  • Contact precautions should be used
  • Hand Hygiene should be completed as per the 5 moments in line with usual practice.
  • Eye protection should always be risk assessed and used with any patient where there is a risk of splashes including spitting and productive coughing.
  • Gloves and Aprons should be worn.
  • The patient should ideally be transported via ambulance (eg. PCS) with no other patients present where possible. Individual cases can be discussed with the IPC team and a risk assessment can be made.
  • Laundry should be treated as contaminated, placed into an alginate bag and placed into a red laundry bag.
• What cleaning is required?

  All equipment and the ambulance should have an in-between patient  clean paying particular attention to touch points.

• Do staff need any prophylaxis or follow up?

  Staff do not need to be followed up.