ESBL in Urine

ESBL means – ‘Extended Spectrum Beta Lactamases’. These are bacteria which produce an enzyme –  also called ESBL. This enzyme make the bacteria immune to antibiotics. ESBLs can live in the bowel for many years without affecting the person at all. In some cases, it can cause an infection too.When the person is low on immunity like- cancer patients undergoing chemotherapy, then these bacteria attack the patients body. The infection is difficult to treat because the bacteria is resistant to common antibiotics. Early detection of the infection is important so that bacteria can be removed before they make a colony in the bowel. An infected person can spread the disease to others.

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Causes of ESBL in Urine

Following people are infected with ESBL-

1.            Those who have taken lots of antibiotics due to some disease. The reason is that the bacteria are attracted to antibiotics and ESBL have a tendency to quickly develop resistance to the medicine so that it does not work anymore.

2.            It is contagious and hence can be transferred to any person who comes in contact with the infected person or his/her personal belongings. It spreads in hospitals by touching the bed rails, equipment or using the toilet of the infected person.

Precautions

Mostly the bacteria affects the following parts-

  • Respiratory tract
  • Intestines
  • Urinary tract

Urinary Tract Infection or UTI is become very common these days. Following precautions can be helpful-

1.)                Keep your hands clean. Wash them often.

2.)                In Hospitals, the staff must wear gloves and apron. This infection is very common in hospitals. Patients suffering from diarrhea increases the risk factor of spreading the infection.

3.)                Patients suffering from ESBL infection must be isolated in hospitals.

4.)                Visitors must be given prior instructions to prevent from any such infection.

Risk Factors

People have UTIs when they have a history of recurring UTIs due to ESBL, cognitive impairment, improper nutrition, weak immune system or other diseases.

The presence of ESBL in urine leads to Urinary tract infection which is very much prevalent these days. It is because of the improper hygiene in the localities. This occurs especially in hospitals due to absence of isolation for already infected patients. It is highly contagious and hence extra care is important.

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Symptoms

Symptoms of UTI due to ESBL may include any of the following-

  • Pain and burning sensation while urination.
  • Nausea and Vomiting
  • Slight Fever
  • Pain in abdomen
  • Loss of appetite
  • Uneasiness due to frequent Urination

Diagnosis

  • Urine Test , Blood Test
  • Swab of Throat or Rectum

These samples are tested for the presence of bacteria. Then the type of the bacteria is determined.

ESBLs are gram negative bacteria. UTIs are mainly caused by – E.Coli.

Treatment

Since the bacteria- ESBL are resistant to most of the antibiotics, the doctors will have to plan out the course of treatment for the type of bacteria that attacked. Few antibiotics may work to subside the infection.

Also, It is important to take stringent steps to avoid the spread of this infections.

Hand Washing, Isolation, wearing gloves and apron are few very important points to keep in mind.

Usually in 80%-85% cases the microbe is E.Coli when there is UTI by ESBL. So in such a case the treatment is easy and simple. Short Therapy courses cure the problem in 3-4 days only. But if the cause is some other complicated microbe then it takes time to detect which antibiotic must be given and which is to be deferred. Administering wrong antibiotics may attract more microbes to form colonies in the gut.So, proper tests are a precursor to start any treatment.

In some cases, E.coli is multi-drug resistant and then the treatment may go for as long as 5-6 months. As we recover from infection, we may still have ESBL bacteria in the bowel, urinary tracts etc.  Antibiotics must be taken with care as they may attract more of the bacteria in the body.

People carry the ESBL for many years without any infection. Generally, people with weak immunity are affected. Most children are found to carry ESBL and hence parents must regularly check for any infection. Hospitals must incorporate methods for immediate isolation of an ESBL infected person and announce for proper precautions to be taken by the whole staff. We must keep our hands and clothes clean and exercise due hygiene.

Keep away from possible places of infection like hospitals.There is an alarming need of oral antibiotics for the treatment of complicated UTIs and develop new treatment methods  as the ESBLs may become resistant to the newer antibiotics as well.

Carbapenem– An intravenously administered drug used against ESBL infection is losing its effect as the bacteria are found to have become resistant to it. Earlier, It was one of the best methods of treatment. Fosfomycin, and tigecycline are two new drugs with a good success rate in fighting against a certain kind of ESBL infection.

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