ESBL infection is a disease that is difficult to treat because of the pathogens, many of which are resistant, and has become widespread in some areas.
What is ESBL infection?
As part of a definition of the disease known by the acronym ESBL infection, it is important to spell out the acronym. An ESBL infection means an impairment of the organism by bacteria specialized in extended spectrum beta lactamase. At first glance, these bacteria are not easily associated with an infectious disease. ESBL infection occurs primarily in the intestinal system and is based on impairment due to inactivation of antibiotic drugs by enterobacteria. In ESBL infection, this is based on the alteration of the enzyme beta lactamase achieved by pathogenic bacteria, which interrupts the action of antibiotics. This ability is possessed by various bacterial strains of enterococci. As a result of these processes, ESBL infection leads to resistance to antibiotics. In the case of an ESBL infection, this leads to the fact that other diseases can hardly or not at all be treated with antibiotics.
Causes
Causes of ESBL infection include, in particular, the pathogens known as gram-positive enterobacteria. These bacteria are present in the intestine of a healthy person, are also absorbed from the environment, and contribute to the functioning of the intestinal flora. By interfering with the healthy genetic genetic information of the enterobacteria, ESBL infection can occur. Thus, the causes of ESBL infection are genetically altered germs of the intestine. ESBL infection occurs predominantly in people who have a weakened immune system. In the case of ESBL infection, these are predominantly sick, elderly people and very young children. For this reason, ESBL infection occurs predominantly in the context of hospitalism in hospitals and nursing homes and can also be transmitted through excreta such as feces.
Symptoms, complaints, and signs
In general, ESBL infection does not present with complaints and symptoms that are particularly characteristic of the disease. The complaints here depend very much on the exact location of the infection, with each person also reacting differently to ESBL infection. As a rule, this infection causes an infection of the urinary tract, which is associated with severe pain during urination. This pain is felt as burning or stabbing. Likewise, the patient’s wound healing is generally significantly slowed down, so that injuries or cuts can only heal very slowly. The infections can also spread to the internal organs and cause irreversible damage to them. In the worst case, this can lead to the death of the person affected by the ESBL infection. ESBL infection also frequently leads to inflammation of the lungs, which is associated with severe breathing difficulties and restrictions in everyday life. If the pneumonia is not treated, it can also develop into a chronic disease. In general, most of those affected by the ESBL infection also appear tired and fatigued and no longer actively participate in everyday life. Pus often forms on wounds due to ESBL infection, and the wound may also have an unpleasant odor.
Diagnosis and course
A definitive diagnosis of ESBL infection can only be made after comprehensive laboratory examination and testing of patients. In this context, samples of excreta as well as swabs of mucous membranes and wounds are taken to examine them for the presence of germs of ESBL infection. Microbiologically, the evaluation of the results shows the presence of the enterobacteria for ESBL infection as well. Those affected carry the ESBL infection to the extent that the germs are present in increased numbers in the mucous membrane of the colon, the urinary and respiratory tracts, where they lead to pathological symptoms. In ESBL infections, many enterobacteria are present at the entrance to the urethra. In this context, the course of ESBL infection is problematic in ventilated patients and patients in need of care, in whom the pathogens of the ESBL infection can also contribute to diseases of other organs. Typical forms of ESBL infection are urinary tract infections that cannot be treated, wounds that heal poorly, and pneumonia.In terms of wound healing disorders, ESBL infection is characterized by brownish wound edges with pus and a strong odor of decay from the wounds.
Complications
A variety of symptoms and complications can result from ESBL infection. These depend greatly on the spread of the pathogen and on the affected body region. For this reason, a general prediction is usually not possible. However, problems with the stomach and intestines often occur. The affected person suffers from diarrhea and vomiting. A general feeling of illness and weakness sets in. The patient is no longer able to perform physical activities or sports. In many cases, the kidneys and urethra are also affected, so that urination is associated with pain. The quality of life is greatly reduced by the ESBL infection. In some cases, the respiratory tract is also infected, so that breathing difficulties may occur. This can also lead to pneumonia. Treatment proves complicated because the germs are resistant to common antibiotics. As a rule, a stay in hospital is necessary in the case of an ESBL infection. If the infection is treated successfully, there are no further complications and life expectancy is not reduced.
When should you go to the doctor?
If unusual infections are noticed on the skin, in the lungs, or in the urinary tract, a doctor should be consulted. ESBL infection can cause a wide variety of symptoms and should therefore be diagnosed or ruled out by a doctor at the first suspicion. Anyone who experiences symptoms mentioned after contact with foreign body fluids or animals should see a doctor immediately. People with a weakened immune system, renal insufficiency or decubitus ulcers are particularly at risk. So are bedridden people and elderly patients who are dependent on a permanent catheter or dialysis. Anyone who belongs to these risk groups is best advised to clarify the typical signs immediately with the responsible physician. Parents who suspect an ESBL infection in their child should make an appointment with their pediatrician. Medical advice is needed at the latest when complications such as diarrhea and vomiting as well as a general feeling of weakness are noticed. As the disease progresses, increasing respiratory problems indicate a serious underlying illness that must be clarified and, if necessary, treated in the hospital.
Treatment and therapy
Treatment of ESBL infection is possible to a limited extent, especially since those affected predominantly become ill in clinics, hospitals, and inpatient care facilities. The multidrug-resistant germs that are insensitive to many antibiotic drugs in ESBL infection can be treated with quite few antibiotics. In addition, the treatment of ESBL infection is also primarily concerned with the treatment of the secondary diseases that are evident in the current state. To treat ESBL infection, the ESBL-forming bacteria must be eliminated from the organism. This is hardly feasible in ESBL infection, as there are hardly any effective antibiotics available. In some cases, patients are treated with a so-called highly potent antibiotic known as oxazolidinone under the name linezolid. In the application against the germs that are possible triggers of ESBL infection, drug-specific antibiotics such as quinupristin, daptomycin, tigecycline are also available and have been used for some time.
Outlook and prognosis
ESBL infection is a difficult-to-treat disease with a usually unfavorable prognosis. The disease triggers are multidrug-resistant germs for which many drugs are ineffective. If a drug can be found to which the organism responds, the prognosis improves. With the current medical possibilities, this development can only be documented in a few patients. In these cases, the spread of the symptoms can be contained and, in addition, there is a regression of the symptoms. In most cases, patients are already in an inpatient or clinical stay at the onset of the disease. They are ill and have a weakened immune system due to the circumstances. These conditions complicate therapy and have a negative impact on overall treatment success. The ESBL infection is often described as not treatable.In very many patients, the course of the disease is chronic, with the ultimate aim of preventing the onset of further diseases. If complications occur, the prognosis deteriorates further. The patient is at risk of sepsis if wound healing is impaired. This poses a potential threat to life. In addition, the risk of pneumonia is increased. This condition can also lead to premature loss of life in severe cases.
Prevention
Prevention of ESBL infection is based predominantly on comprehensive hygienic and disinfection- and sterilization-related measures. These prevent transmission of the bacteria to other compromised individuals and must be adhered to, particularly by clinical and nursing staff in known cases of ESBL infection. To prevent infection of an ESBL infection, mainly the so-called hand hygiene plays an important role.
Follow-up
In most cases of an ESBL infection, no special measures or options for aftercare are available to the affected person. In this case, the patient is primarily dependent on early diagnosis and treatment to prevent worsening of symptoms or further complications. However, the disease can be treated relatively well if it is detected early. After successful treatment, there is still no need for special measures of follow-up care. In order to prevent ESBL infection, the affected person should take special care to disinfect and maintain a high standard of hygiene. In most cases, ESBL infection is treated with the help of antibiotics or other medications. It should be noted that the antibiotics should not be taken together with alcohol, otherwise their effect is reduced. At the same time, these drugs should usually be taken even after the symptoms have subsided in order to completely defeat the disease. During treatment, bed rest should be observed and strenuous or stressful activities should be refrained from. No other measures are necessary for treatment. With complete treatment, there is no decreased life expectancy for the affected individual.
What you can do yourself
ESBL infection is composed of predominantly antibiotic-resistant bacteria acquired through nonsanitary conditions. Self-care measures are limited. In case of infection, emergency medical services should be involved. The symptom massively affects the urinary and intestinal systems, as well as the skin and respiratory tract. Affected individuals are treated clinically and must adhere to various precautions after successful recovery. Most patients, seniors, children and chronically ill persons who fall prey to an ESBL infection have a weakened immune system. Therefore, this group of people should generally ensure that they live in a hygienically clean environment in their daily lives. This includes proper washing of clothing, especially work clothes, and daily personal hygiene. In the occupational area, the prescribed disinfection standards must be observed, as they serve to protect oneself and others. For the use of public toilets, it is advisable to carry a disinfectant spray, since the infection of the symptom can also occur through doorknobs and toilet seats. As a top self-help, the immune system must be strengthened in the long run. This includes giving up smoking as well as alcohol, medication and drug abuse. Sufficient exercise, sauna visits and diet also play a major role in strengthening the immune system permanently. The diet should contain healthy fiber, be low in fat, rich in vitamins and minerals, and contain beneficial fatty acids such as omega-3 and omega-6.