ESBLs or extended-spectrum beta-lactamases are enzymes produced by certain bacteria . This enzyme causes bacteria to be resistant to antibiotics that usually kill them. This is what makes ESBL-producing bacterial infections difficult to treat.
Escherichia coli ( E. coli ) and Klebsiella pneumonia are the bacteria most commonly found as ESBL-producing bacteria. Generally, these two bacterial infections can be treated with ordinary antibiotics, such as penicillins and cephalosporins .
However, ESBL creates resistance to these antibiotics so stronger antibiotics are needed to overcome them.
The following is a further explanation of E. coli and Klebsiella pneumonia :
-
Escherichia coli ( coli )
These bacteria are naturally present in the intestines and are generally harmless. However, some types of E. coli can also infect the body and cause disease. This infection can be transmitted through food, drink, or contact with an infected person.
-
Klebsiella
This bacterium is found in the intestines, mouth and nose of humans. Although generally harmless, Klebsiella can also cause nosocomial infections , namely infections that are spread in health facilities.
Causes of ESBL Producing Bacterial Infections
ESBL-producing bacterial infections can spread between humans through direct touch, contaminated objects, or splashed saliva from infected people.
Generally, ESBL-producing bacteria are widely found in health facilities, such as hospitals. For example, a person can catch the bacterium by shaking hands with a healthcare worker who is likely to frequently touch contaminated surfaces.
Risk factors for infection with ESBL-producing bacteria
There are a number of factors that can increase a person's risk of developing an ESBL-producing bacterial infection, namely:
- Frequent contact with patients with infectious diseases, for example because they work as doctors or nurses in hospitals
- Undergo long-term hospital care
- Have a history of taking antibiotics recently or in the long term, especially high-dose antibiotics
- Using IVs, urinary catheters, and endotracheal tubes (ETT)
- Experiencing an injury that resulted in a wound, such as a burn
- Undergoing surgery
- Suffer from a chronic (long-term) disease, such as diabetes
- Aged
Symptoms of ESBL Producing Bacterial Infection
Symptoms of ESBL-producing bacterial infections can differ, depending on the infected organ and the type of bacteria. This infection is most common in the urinary tract and intestines.
In urinary tract infections , symptoms that may arise are:
- Burning feeling when urinating
- Urinate often, but little by little
- Urine is cloudy or reddish in color
- Lower abdominal pain
If an ESBL-producing bacterial infection occurs in the intestine, symptoms will appear in the form of:
- Diarrhea
- Loss of appetite
- stomach cramps
- Flatulence
- Fever
ESBL-producing bacteria can also attack the skin, especially in open wounds. Symptoms that can appear are redness and discharge in the infected area.
When to see a doctor
Check with your doctor if you experience the symptoms mentioned above, especially if you have factors that can increase your risk of being infected with ESBL-producing bacteria.
You also need to see a doctor immediately if you have a fever that doesn't improve after 3 days of taking antibiotics prescribed by a doctor or suffer from diarrhea that doesn't improve or is even accompanied by blood.
Diagnosis of ESBL Producing Bacterial Infections
The doctor will begin the examination by asking about the symptoms experienced, medical history, and medications that the patient is currently taking. Next, the doctor will carry out a thorough physical examination.
To make a diagnosis, the doctor will carry out further examinations, namely:
- Taking blood, urine, or wound fluid samples, to detect bacterial infections
- Antibiotic resistance test, to detect whether bacteria produce ESBL or not
If an ESBL-producing bacterial infection is confirmed, the doctor will conduct an examination to find out which type of antibiotic is effective in treating the patient.
Treatment of ESBL Producing Bacterial Infections
Treatment of ESBL-producing bacterial infections will be adjusted according to the bacteria causing the infection. Generally, treatment is done by administering drugs. However, the medicines that can be given are limited because this infection makes the bacteria resistant to antibiotics.
Even so, ESBL-producing bacterial infections can be overcome if the right antibiotics are found. Medicines that doctors commonly use to treat this condition include:
- Carbapenem class of drugs
- Fosfomycin
- Beta-lactamase inhibitor class drugs, such as sulbactam and tazobactam
- Non-beta-lactam antibiotics, eg macrolides
- Colistin
Keep in mind that the consumption of the antibiotics above or any antibiotics must be accompanied by a doctor's direction. This is because each patient has a different condition so that the type of drug, drug dosage, and duration of use can also be different.
In some cases, ESBL-producing bacterial infections need to be treated in hospital. Patients may also be treated in an isolation room to ensure the bacteria is not transmitted to other people in the hospital.
Complications of ESBL Producing Bacterial Infections
If the bacteria are resistant to many antibiotics, the treatment of ESBL-producing bacterial infections becomes difficult and can be protracted. In addition, if treatment is delayed, the infection can develop and cause more severe symptoms, even death.
ESBL-producing bacteria can also spread and enter the bloodstream ( sepsis ). If this condition occurs, the symptoms that appear are:
- Fever
- Shivering
- Nauseous
- Vomiting
- Hard to breathe
- Confusion
Prevention of ESBL Producing Bacterial Infections
Some things that can be done to prevent transmission of ESBL-producing bacterial infections include:
- Always wash your hands properly after doing activities or before touching your face and mouth
- Avoid sharing personal items, such as towels or clothes
- Maintain cleanliness of toilets
- Always consume food or drink that has been pasteurized or cooked thoroughly
- Cleaning the house regularly
If you suffer from an ESBL-producing bacterial infection and are being treated at home, several ways that need to be implemented to prevent transmission are:
- Keep your hands clean by washing your hands regularly
- Do not share food or personal items, such as towels, with other household members
- Wash clothes with warm water and detergent
- Reducing interaction with other residents in the house and the outside environment