Extended-spectrum beta-lactamase-producing organisms (ESBL)
ESBL precautions
- How long
- No fixed duration in CDC’s table — set by facility policy
- Room
- Single room preferred; cohort with patients who have the same MDRO
- PPE
- Gown and gloves on room entry
- Colonized patients
- Included — CDC’s MDRO row covers infection or colonization
- New or emerging MDROs
- Contact your state health department for guidance
Good to know
- CDC’s multidrug-resistant organisms row names ESBLs explicitly, alongside MRSA, VRE, VISA/VRSA and resistant S. pneumoniae.
- CDC leaves the choice of which MDROs need Contact Precautions to each facility’s infection prevention program, based on local, state, regional or national recommendations. CDC recommends them in settings with ongoing transmission, in acute care settings with an increased risk of transmission, and for wounds that cannot be contained by dressings.
- In nursing homes, CDC guidance allows Enhanced Barrier Precautions (gown and gloves during high-contact care activities) for many residents with MDROs instead of full Contact Precautions.
What CDC’s table says
Verbatim from CDC’s Appendix A, with bibliography numbers removed.
Multidrug-resistant organisms (MDROs), infection or colonization (e.g., MRSA, VRE, VISA/VRSA, ESBLs, resistant S. pneumoniae)
ContactStandardMRSA guideDuration—
MDROs judged by the infection control program, based on local, state, regional, or national recommendations, to be of clinical and epidemiologic significance. Contact Precautions recommended in settings with evidence of ongoing transmission, acute care settings with increased risk for transmission or wounds that cannot be contained by dressings. See recommendations for management options in Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006. Contact state health department for guidance regarding new or emerging MDRO.
Test yourself: a CIC-style question
Under CDC’s isolation guideline, which precautions apply to a patient with an ESBL-producing organism that the infection prevention program has judged significant?
- Standard Precautions only
- Contact + Standard Precautions
- Droplet + Standard Precautions
- Airborne + Standard Precautions
Show answer
B. Contact + Standard Precautions
ESBL producers are multidrug-resistant organisms. CDC’s Appendix A lists MDROs of clinical and epidemiologic significance under Contact + Standard Precautions.
Questions like this come up in the Preventing and Controlling the Transmission of Infectious Agents domain of the CIC® exam. The 654 questions in the app each come with a written explanation.
FAQ
- What precautions are needed for ESBL?
- Contact + Standard (when your infection prevention program applies them). Room: Single room preferred; cohort with patients who have the same MDRO. PPE: Gown and gloves on room entry. Colonized patients: Included — CDC’s MDRO row covers infection or colonization. New or emerging MDROs: Contact your state health department for guidance.
- How long do ESBL precautions last?
- No fixed duration in CDC’s table — set by facility policy.
Sources
- CDC. Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions (2007 Guideline for Isolation Precautions, updated September 2024)
- CDC. Infection Control Guidance: Candida auris
Checked against CDC on October 21, 2026. For education and CIC® exam preparation only — not a substitute for your facility’s infection prevention policies, your state or local health department, or clinical judgment. CBIC and CDC do not endorse this tool.