Extended-spectrum beta-lactamases (ESBL) are a type of enzyme or chemical produced by some bacteria. ESBL enzymes make some antibiotics ineffective in treating bacterial infections.

Common antibiotics, such as cephalosporin and penicillin, are often used to treat bacterial infections. With ESBL infections, these antibiotics can become useless.

Bacteria use ESBLs to become resistant to antibiotics. The most common types of bacteria that produce ESBLs include:

  • Escherichia coli (better known as E. coli): This is a normally harmless bacteria that lives in your gut, but it can also cause infections and food poisoning.
  • Klebsiella: This is another harmless bacteria that lives in your mouth, nose, and gut. But it can also cause conditions such as urinary tract infections. It’s been found in colonies in hospital environments and can cause infections within hospitals to spread.

E. coli and Klebsiella infections can usually be treated with normal antibiotics like penicillin and cephalosporin. But when these bacteria produce ESBLs, they can cause infections that can no longer be treated by these antibiotics. In these cases, your doctor will find another treatment to stop the new infection that’s become resistant to antibiotics.

ESBL transmission

You can get ESBLs from touching water or dirt that contains the bacteria. This is especially possible with water or soil that’s been contaminated with human or animal fecal matter (poop). Touching animals that carry the bacteria can also spread the bacteria to you.

Certain infections that can also develop resistance to antibiotics can increase your risk of getting a bacterial infection with ESBLs, such as MRSA (a staph infection).

You can spread an ESBL infection simply by touching someone or leaving bacteria on a surface that someone else touches. This can include:

  • shaking hands
  • breathing on someone
  • handling an object that is then handled by someone else


In some cases, you may spread bacteria with ESBLs without even having an infection yourself. This is called colonization. When this happens, your body is carrying the bacteria with ESBLs but isn’t actively infected. You don’t need to be treated while you’re colonized, but you can still pass on an infection to someone else. They will then need to be treated.

Where are ESBLs commonly spread?

Bacteria with ESBLs are especially common in hospitals. They are spread most easily by doctors, nurses, or other healthcare professionals who touch people, objects, or surfaces in facilities where the bacteria live.

Conditions and infections that can be caused by ESBL-producing bacteria include:

  • urinary tract infection (UTI)
  • diarrhea
  • skin infections
  • pneumonia

Symptoms of an ESBL infection depend on what type of bacterial infection has produced the ESBLs.

If you have a UTI, you may have to urinate more often than normal and you may feel burning when you urinate. If you have a skin infection with ESBL, you may see reddened skin around the site of the infection and fluid coming out of the area.

If the infection is in your gut, you may notice the following symptoms:

  • loss of appetite
  • blood in your stool
  • stomach cramps
  • diarrhea
  • excessive gas or bloating
  • fever

If the ESBL infection has gotten into your blood, you may have one or more of the following symptoms:

  • feeling disoriented
  • fever
  • feeling chills
  • nausea
  • vomiting
  • trouble breathing


Possible medications used to treat ESBL infection include:

  • carbapenems, which are useful against infections caused by E. coli or Klebsiella pneumoniae bacteria
  • fosfomycin, which is effective against ESBL bacterial infections
  • beta-lactamase inhibitors
  • nonbeta-lactam antibiotics
  • colistin, which is prescribed in rare cases when other medications have failed to stop the ESBL infection

Lifestyle remedies

If you have a ESBL colonization in your body but don’t have an active infection, your doctor may recommend a special nutrition and hygiene plan. That will help prevent an infection from breaking out. Your doctor may also ask you to wash anything you’ve touched. They may ask you to avoid contact with people until the colonization has been dealt with.

Washing your hands is the best way to prevent the spread of ESBL bacterial infections. Handwashing is especially important if you’re in a hospital or other healthcare facility. Wash your hands if you’ve come into contact with someone who’s recently had an infection.

Wear gloves when you’re around someone with an infection or handling objects in a hospital or healthcare facility. The gloves can also help protect you from picking up the ESBL bacteria. Wash your clothes, bedding, or other materials that you’ve touched, worn, or slept in while you’ve had an ESBL infection. This can keep the bacteria from spreading.

If you have an ESBL infection while you’re in the hospital, your doctor may want to keep you in contact isolation. In this case, you’ll stay in an area of the hospital where your infection can be contained and won’t spread to other people staying in the facility. Depending on how severe your infection is, you may need to be in isolation for a few hours to a few days.

Most ESBL infections can be treated successfully once your doctor has found a medication that can stop the resistant bacteria. After your infection is treated, your doctor will likely give you good hygiene practices. These can help ensure you don’t develop any other infections that can also resist antibiotics.