Is basic hygiene enough when it comes to ESBL bacteria?

It depends on the resistance pattern of the pathogen and the patient’s health risk.

Background:

ESBL bacteria are Enterobacteriaceae. They can produce enzymes with an expanded beta-lactamase spectrum, so-called extended-spectrum beta-lactamases (ESBL). The bacteria are resistant to important groups of antibiotics, such as aminopenicillins and third-generation cephalosporins, and also some types within the carbapenem reserve group antibiotics.

Experts recommend individualized, risk-based hygiene management. A situation is evaluated according to the following criteria:

1. The resistance pattern, i.e., which antibiotics the germs are resistant to and which other treatment options are available?
2. The risk for other patients and flatmates, i.e., if other patients are highly susceptible to infections, the hygiene regime must be more rigid.

Depending on these factors, basic hygiene could either be enough, or more severe measures need to be taken, such as barrier care and isolation.

References:
KRINKO (2012) Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen. Bundesgesundheitsbl 55:1311-1354.