From the Research
The prevalence of Extended-Spectrum Beta-Lactamase (ESBL) producing organisms in ICU patients is approximately 55.4%, as reported in a recent study 1. This high prevalence is a concern, as ESBL-producing organisms are resistant to many antibiotics, making treatment challenging. The most common ESBL-producing organisms in ICU settings are Escherichia coli and Klebsiella pneumoniae. Risk factors for ESBL colonization or infection include:
- Prior antibiotic exposure, especially third-generation cephalosporins and fluoroquinolones
- Prolonged hospitalization
- Mechanical ventilation
- Presence of invasive devices
- Recent surgery For empiric treatment of suspected ESBL infections in ICU patients, carbapenems, such as imipenem, are typically recommended as first-line therapy until susceptibility results are available 1. Active surveillance through rectal swabs or stool cultures upon ICU admission can help identify colonized patients early, allowing for appropriate isolation precautions to prevent transmission. Implementation of antimicrobial stewardship programs and strict infection control measures are essential to limit the spread of these resistant organisms in critical care settings. It is also important to note that the use of carbapenems as definitive therapy has been associated with a significantly lower 21-day mortality in patients with bloodstream infections due to ESBL-producing Enterobacteriaceae 2. Overall, the high prevalence of ESBL-producing organisms in ICU patients highlights the need for vigilant infection control measures and appropriate antibiotic use to prevent the spread of these resistant organisms.