Extended spectrum beta-lactamases (ESBLs) are enzymes made by bacteria. They make it harder for the usual medicines to care for infections. Without them, getting sick can lead to serious health problems or death.

The Intestines

The bacteria can travel to the intestines, causing a serious infection.

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Certain bacteria cause the infections. Some people carry them without being sick, but can spread it to others.

Risk Factors

The most common place to have contact with these germs is from a hospital stay. The healthcare staff spread germs by touching people. The most common type is a urinary tract infection.

Risk also comes from:

  • Recent surgery
  • A tube to drain urine from the bladder
  • History of antibiotic use
  • Living in a nursing home
  • A feeding tubes
  • A ventilators —to help with breathing
  • Dialysis —to help your kidneys clean your blood
  • Having diabetes


Symptoms depend on the where the infection is. These may be:

  • Fever or chills
  • Belly pain
  • Pain and burning when passing urine
  • Signs of infection around a wound such as redness or warmth
  • Diarrhea
  • Loss of hunger
  • Nausea and vomiting
  • Breathing problems


The doctor will ask about your symptoms and health history. You may have:

  • A physical exam
  • Urine tests
  • Blood tests
  • Stool tests
  • Swabs for cultures


Only certain antibiotics can treat ESBL infections.


To lower the chances of infection, healthcare staff will make sure people:

  • Wash their hands before and after touching you or other surfaces.
  • Wear a gown or gloves when they’re with you.

You can lower your chances by:

  • Washing your hands often.
  • Using antibiotics as advised.
  • Avoiding people who are sick.
  • Calling your doctor when you’re sick.

Centers for Disease Control and Prevention

National Institute of Allergy and Infectious Diseases


Alberta Health

Public Health Agency of Canada


Antibiotic/antimicrobial resistance. Centers for Disease Control and Prevention website. Available at: Updated March 29, 2018. Accessed May 21, 2018.

Dhillon RH, Clark J. ESBLs: a clear and present danger? Crit Care Res Pract. 2012;2012:1-11.

Doi Y, Adams J, O'Keefe Alexandra, Quereshi Z, Ewan L, Paterson DS. Community-acquired extended spectrum beta-lactamase producers, United States. Emerg Infect Dis. 2007;13(7): 1121-1123.

Extended spectrum beta-lactamases (ESBLs). EBSCO DynaMed Plus website. Available at: Updated November 7, 2017. Accessed May 21, 2018.

Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev. 2005;18(4):657–686.

Last reviewed May 2018 by David L. Horn, MD, FACP  Last Updated: 5/21/2018