Infection Prevention and Control Team ESBL and AmpC Information for patients,
relatives and carers
This information sheet has been provided to help answer some of the questions you may have about ESBL and AmpC producing bacteria. Will visitors or family members be at risk? The bacteria do not pose a danger to otherwise healthy people, including children. Sick people in hospital are more at risk of infection because of illness or drugs weakening their body’s defence mechanisms. What is ESBL? ESBL stands for Extended Spectrum Beta Lactamase. An enzyme (chemical) which some bacteria like Escherichia coli and Klebsiella pneumonia produce (coliforms). Visitors will be requested to wash their hands or use the hand gel on entering and leaving your room. Please do not allow your visitors to sit or lie on your bed. Ask your visitors to take your dirty clothes home as soon as possible to be washed in the usual way. ESBL enzymes have developed resistance to some antibiotics. It is this resistance that makes ESBL infections more difficult to treat due to the limited choice of antibiotics. What is AmpC? How does the bacteria spread? AmpC is an enzyme which works in a similar way to ESBL but is rarer. If an infection is caused by a bacteria producing the AmpC enzyme it may be more difficult to treat. ESBL/AmpC producing bacteria are found in both the community and hospital environment. They can be spread accidently via faecal contamination of hands and objects and then passed into the mouth. How could ESBL or AmpC affect me? They can also be spread on the hands of patients, relatives and healthcare workers after contact with an infected patient or equipment, if hands are not washed properly. Common bacteria that produce this enzyme can live within the body (usually the gut) without causing any problems. This is known as colonisation instead of infection. Infection from these bacteria often occurs in the urine, causing a urinary tract infection, but it can also be found in wounds, lungs and blood. If the bacteria enter the blood stream, they can cause blood poisoning, which can be life threatening. How can the spread of infection be limited?  Thorough hand washing, particularly before and after eating  Thorough hand washing after using the toilet  Keeping wounds covered and clean  Minimising the use of antibiotics to ensure they are only prescribed when needed, in the right dose, for the right length of time to reduce resistance developing in bacteria. ESBLs are only detected by a laboratory ‐ they are not related to symptoms. Who is at risk? People who have medical problems and who are already sick and the elderly are at risk from these bacteria. Other people at risk are those who have been taking antibiotics or who have been previously hospitalised. People who have urinary catheters are particularly at risk. 2
What will happen whilst I am in hospital? After leaving hospital If you come into hospital as a patient again, or have to see a doctor about an infection, it is important to mention that you have had this bacteria so that staff can prescribe the correct antibiotics for you. The healthcare staff looking after you will wear yellow aprons and gloves. The nursing staff may need to ask you regularly for a urine sample for testing. If you have a wound the nursing staff may need to take a swab for testing. If you have any queries or concerns about your condition, please do not hesitate to speak to the nurses and doctors looking after you. How is ESBL or AmpC treated? Further information Despite being resistant to some antibiotics, if you are unwell, treatment options are still available. If antibiotic treatment is necessary your doctor will discuss this with you. These may be tablets or given intravenously (injected into a vein). Any wounds will be covered. You may need to stay in a single room until the infection has gone. Your GP surgery If you have an infection caused by these bacteria or carry these bacteria without symptoms, you may be cared for in a side room or you may share a room with other patients with similar conditions. Public Health England www.gov.uk/phe Infection Prevention and Control Team If you do not have any symptoms and you do not feel ill, you may not require treatment. However, you will usually stay in a single room.  Andover War Memorial Hospital Telephone: 01962 825156  Basingstoke and North Hampshire Hospital Telephone: 01256 486774 When can I go home?  Royal Hampshire County Hospital Telephone: 01962 825156 If you are feeling well and the doctors are happy with your condition, you will be allowed to go home. If you live in a nursing home or are in a residential care home, the ward staff will need to speak to the home about the infection you have had. This should not delay you leaving hospital if you are ready to leave. www.hampshirehospitals.nhs.uk Infection Prevention and Control Team May, 2013 Review May, 2014 FCS/ 031/ 2013 © Hampshire Hospitals NHS Foundation Trust 3