Esbl

[Bird2]

Are any of you seeing residents with ESBL? I'm curious of what type of Isolation you are using. We currently use Contact isolation with an emphasis on gloves and hand hygiene. It has been suggested that the ESBL residents don't need isolation but I am in disagreement since it is a MRO and our residents who are immunocompromised would be at risk.. Your thoughts/comments would be appreciated.

[papawjohn]

Hey Bird

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....

Papaw John

[CapeCodMermaid, RN]

ICU nurse, Labor and Delivery, LTC....germs are germs no matter where you may find them!!! Always great to share info and ideas with nurses from every specialty.

[evalesco]

I believe it is standard contact precautions. At least where I go to it is.