ESBLs (Extended Spectrum Beta-Lactamases)

ESBLs are genetic diseases caused by a single defective gene. They affect children born with two copies of the defective gene, but not adults or older siblings. Most common type of ESBL is called Extended Spectrum Beta-Lactamase (ESBL) Type 1 (ESBL1), which affects about one out of every four babies in developed countries. Other types include:

The most common signs and symptoms of ESBL1 are diarrhea, abdominal pain, vomiting, weight loss, fatigue and hair loss. These may last from several days to years.

There is no cure for ESBL1. Treatment consists of maintaining hydration levels through fluids such as water and milk; eating foods high in calcium like dairy products; taking antibiotics to prevent infection; and giving blood transfusions if needed.

Esbilac, a drug used to treat some forms of cancer, is also effective against ESBL1. However, it can cause side effects including liver damage and death.

In the United States, there are currently no FDA approved treatments for ESBL1. If you have any questions about your family member’s diagnosis or treatment options please contact your healthcare provider or call the National Institute of Diabetes & Digestive and Kidney Diseases at 800-342-2383.

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Antibiotic resistance is a hot topic nowadays. There are several types of Antibiotic resistance.

One of these topics is the extended-spectrum beta-lactamases (ESBLs). These can be very dangerous for people who take antibiotics and for the world in general. Infectious disease doctors have been trying to curb this for years now. You can be affected by this type of Antibiotic resistance if you take antibiotics.

This paper will discuss the following topics:

What Are Antibiotics?

What Are Antibiotic Resistance Mechanisms?

What Are ESBLs?

What Diseases Can Be Caused By These Mechanisms?

What is Antibiotic Resistance?

What are Antibiotics?

Antibiotics are a chemical or natural substance that can kill some types of bacteria or other microbes but not others. They do not kill viruses and in most cases they do not kill cancer cells. The original purpose of antibiotics was to treat bacterial diseases, most notably tuberculosis. They were discovered by accident, when Fleming noticed that some of the mold growing in a petri dish was killing off the bacteria he was trying to grow in another petri dish. Antibiotics have saved millions of lives since then. There would have been countless more deaths from disease without them.

What are Antibiotic Resistance Mechanisms?

Antibiotic resistance is a natural process that all bacteria engage in to survive. The resistance mechanisms allow for the bacteria to survive attack by the antibiotic. If an antibiotic succeeds in killing all of the susceptible bacteria, those that have antibiotic resistance mechanisms left will repopulate the environment and their offspring will have the same resistance mechanisms.

The NDM-1 Gene

The New Delhi metallo-beta-lactamase-1 is a gene that confers multi-drug resistance to bacteria (see figure 1). It was first identified in 2010 in a Swedish woman who had recently returned from India.

She was in the hospital for weeks with an infection that did not respond to any of the antibiotics that were tried. Finally, when the doctors sequenced the genome of the bacteria, it was found to contain the NDM-1 gene. The patient recovered after the aggressive use of last line antibiotics.

The problem with this gene is that most bacteria have a hard time surviving with it. The NDM-1 gene produces an enzyme that chews up many antibiotics.

There are new breeds of bacteria out there that are not affected by our antibiotics because they contain this gene. This is an alarming situation that public health officials are monitoring. The CDC has a web page dedicated to dealing with this threat. It can be found at:

The web page mentioned above outlines the following threats:

The NDM-1 gene is found in many different types of bacteria making it very difficult to find a antibiotic that will kill all of them.

NDM-1 is easily transferrable between bacteria types. This means that if you are carrying a resistant strain of bacteria, it can easily transfer this trait to other bacteria making them resistant as well.

The NDM-1 gene ends up making bacteria more virulent (able to cause disease) so even if the antibiotic kills it, the infection may be severe.

NDM-1 allows bacteria to survive in the gut where there are low levels of oxygen.

Sources & references used in this article:

Detection of extended-spectrum beta-lactamases in clinical isolates of Klebsiella pneumoniae and Escherichia coli. by GA Jacoby, P Han – Journal of clinical microbiology, 1996 – Am Soc Microbiol

Controversies about extended-spectrum and AmpC beta-lactamases. by KS Thomson – Emerging infectious diseases, 2001 – ncbi.nlm.nih.gov

Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment by S Shaikh, J Fatima, S Shakil, SMD Rizvi… – Saudi journal of …, 2015 – Elsevier

Extended-spectrum beta-lactamases in Taiwan: epidemiology, detection, treatment and infection control by WL Yu, YC Chuang… – Journal of Microbiology …, 2006 – tmu.pure.elsevier.com