I gotta admit, I opened this thread 'cause I had no idea what ESBL meant. (Always tryin' to learn something new!!) So I goggled ESBL and found a 'medscape' article about them. This research paper recounted a medical-records search & analysis in a Chicago hospital of ESBL positive Pts over a couple of years. They found that ESBLs (for anyone reading who knows as much as I did a coupla minutes ago: "Estended-Spectrum Beta Lactamases")
are either E Coli (our old friend) or Klebsiella Pneumoniae; that altho the infection is usually thought of as assoc with LTCare--half of their Patients came from home with positive Cxs; that the major risk factor was previous AntiBiotic Rx (what we used to call--an 'opportunistic infection'); and that virtually ALL of them were E Coli in urine. One was E Coli in a wound.
Don't know how that relates exactly to your question about isolation. It seems to me that universal precautions would keep E Coli from moving from a UTI or wound infection to your immune-suppressed Pt. 'Course--I'm an ICU nurse and don't know beans about LTC, so I can't really give you a good answer.
Thanks for the stimulous to learn something new, though....