ESBL-Producing Bacteria

Medically Reviewed by Dan Brennan, MD on June 05, 2021

Extended-spectrum beta-lactamases (ESBLs) are enzymes or chemicals produced by germs like certain bacteria. These enzymes make bacterial infections harder to treat with antibiotics. Here's what you need to know about infections caused by ESBL-producing bacteria and their treatment.

Bacteria That Produce ESBLs

The two most common bacteria that produce ESBLs are E. coli — or Escherichia coli — and Klebsiella pneumoniaeboth of which are found in your gut even when you are healthy.   

Most E. coli strains and types are harmless, but some of them can cause infections leading to stomach pains and diarrhea. Klebsiella pneumoniae may make its way to other parts of your body, causing various infections like pneumonia and urinary tract infections — or UTIs.

E. coli and Klebsiella infections are usually treated with common antibiotics like penicillins and cephalosporins. But, when these bacteria produce ESBLs, they become resistant to these antibiotics.

An ESBL chemically breaks down and destroys its target antibiotic, making it useless against an infection.

In such cases, finding the right medication for the infection becomes challenging, and more complex treatment methods might be needed.

Transmission of Infections Due to ESBL-Producing Bacteria

As with other bacteria, ESBL-producing bacteria can spread from person to person or by contact with a contaminated surface. You may catch such infections simply by shaking hands with an infected person or by touching soiled objects that have not been cleaned thoroughly. The spread of disease-causing bacteria is especially common in healthcare settings, where their numbers in the surroundings are very high.

Infections due to ESBL-producing bacteria are easily spread by healthcare professionals like doctors and nurses who regularly come in contact with contaminated surfaces.

People who are ill or are taking large doses of antibiotics are at a higher risk of getting infected with ESBL-producing bacteria. People receiving treatment in hospitals or care homes are also easily exposed to infections, particularly if they have open wounds, drainage tubes, or catheters.

Symptoms of Infections Due to ESBL-Producing Bacteria

Symptoms in such infections mainly depend on the type of bacteria that cause the infection and the affected area of your body. The most commonly diagnosed sites of infection are the gut and the urinary tract, although the lungs, open wounds, and blood can also get infected with ESBL-producing bacteria.

Symptoms of a UTI may include:

  • Burning sensation or pain when urinating
  • Pressure in the lower belly
  • Cloudy or reddish urine
  • Urge to urinate often

You may notice the following symptoms if you have an infection due to ESBL-producing bacteria in the gut:

  • Stomach cramps
  • Vomiting
  • Diarrhea
  • Loss of appetite

You may also show the following symptoms if the infection has spread to your blood:

  • Fever
  • Aches and pains
  • Weakness
  • Chills
  • Feeling disoriented

Treatment of Infections Due to ESBL-Producing Bacteria

Even though ESBL-producing bacteria have defense mechanisms against several commonly used antibiotics, many other available drugs can be used here. But, if you have a severe infection, you might need to be hospitalized for treatment with intravenous (IV) antibiotics.

Carbapenems are the most commonly prescribed antimicrobial drugs for treating infections caused by highly resistant ESBL-producing bacteria.

Other prescribed medications may include:

  • Ceftriaxone 
  • Cefepime
  • Cefotaxime or aztreonam
  • Cefpodoxime

Prevention and Control of Infections Due to ESBL-Producing Bacteria

Thorough hand-washing and sanitizing are the best way to control the spread of infections caused by ESBL-producing bacteria.

Make sure to clean your hands carefully after using a bathroom and after touching exposed foods like raw meat. If you are around someone with an infection due to ESBL-producing bacteria, special care should be taken to clean frequently touched objects and surfaces.

If you are a healthcare provider, then maintain high standards of cleanliness to prevent care staff from spreading the infection. Also, if you are infected or are caring for someone with an infection caused by ESBL-producing bacteria, follow these good hygiene practices:

  • Clean hands frequently
  • Avoid sharing food or other personal items
  • Wash laundry with detergent and warm water
  • Avoid exposure to public spaces

In some cases of serious infections, you may need to be isolated — or quarantined — while receiving treatment in a hospital. This step is not necessary if you are recovering at home.

General precautions you can take to control the spread of ESBL-producing bacteria are:

  • Maintaining proper hand hygiene
  • Routinely disinfecting surfaces, especially in the kitchen and bathrooms
  • Avoiding touching the face and mouth 
  • Taking prescribed antibiotics exactly as directed

Most infections due to ESBL-producing bacteria can be easily treated with a course of the right antibiotics. Of the many antimicrobial medicines, your doctor will prescribe you drugs based on the bacterial strain and site of infection.

Once the infection has been treated, it is important to follow good hygiene practices so you don't develop another treatment-resistant infection.

WebMD Medical Reference



Centers for Disease Control and Prevention: "E. coli (Escherichia coli)", "ESBL-producing Enterobacterales in Healthcare Settings," "Klebsiella pneumoniae in Healthcare Settings."

Clinical Microbiology and Infection: "Treatment of infections with ESBL-producing organisms: pharmacokinetic and pharmacodynamic considerations."

Current Issues in Molecular Biology: "Extended Spectrum Beta-lactamases: Definition, Classification and Epidemiology." 

Health Service Executive: "ESBLs." 

Indian Journal of Nephrology: "Extended spectrum beta lactamase peritonitis: Our experience." 

Journal of Perinatology: "Extended Spectrum β Lactamase-producing Klebsiella pneumoniae Infections: a Review of the Literature."

National Health Service: "Infection Prevention Management of ESBL." 

National Institutes of Health: "Urinary Tract Infections." 

Public Health Agency: "Extended-spectrum beta-lactamase (ESBL) bacteria." 

Surrey and Sussex Healthcare NHS Trust: "Extended Spectrum Beta-Lactamases (ESBLs) – Escherichia coli (E.coli) and Klebsiella." 

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