EPIDEMIOLOGY AND HEALTH DATA INSIGHTS
Review Article
Oct 26, 2026 5 3

Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthcare Settings: Epidemiology, Risk Factors, Infection Control Strategies and Emerging Treatment Options

Nkemdilim Clairelouise Okechukwu 1 * ,
Theophilus Kachi Udeani 2,
Uzoma Chukwunonso Okechukwu 3,
Ifeoma Esther Ani 4,
Emmanuel Ogbonnia Ogudu 5,
Rita Nnenna Attah 6
1 Department of Medical Microbiology, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria2 Department of Medical Laboratory Science, Faculty of Health Sciences University of Nigeria, Enugu Campus, Enugu, Nigeria3 Department of Internal Medicine, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria4 Department of Medical Microbiology, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria.5 National Arbovirus and Vectors Research Centre, Enugu, Nigeria6 Department of Medical Microbiology, Renaissance University, Enugu, Nigeria* Corresponding Author
Epidemiology and Health Data Insights, 2(5), 2026, ehdi060, https://doi.org/10.63946/ehdi/19671
Publication date: Oct 26, 2026
Full Text (PDF)

ABSTRACT

Antimicrobial resistance continues to threaten the effectiveness of modern antimicrobial therapy, with ESBL-producing Escherichia coli emerging as a major cause of difficult-to-treat healthcare-associated infections. The global spread of these organisms is driven by antimicrobial selection pressure, genetic adaptability and transmission across healthcare, community and environmental reservoirs. This narrative review aimed to synthesise current evidence on the epidemiology, risk factors, transmission pathways, infection prevention strategies, antimicrobial stewardship approaches and emerging therapeutic options for ESBL-producing E. coli in healthcare settings.
A structured narrative review was conducted using literature published between 2016 and the search date (June 6, 2026) indexed in PubMed, ScienceDirect, Dimensions and Google Scholar as well as literature obtained through grey literature search and screening of reference lists.. Relevant studies, including epidemiological investigations, molecular studies, clinical research, systematic reviews, surveillance reports and treatment guidelines, were critically analysed through thematic synthesis.
The review found that ESBL-producing E. coli has become a globally distributed antimicrobial-resistant pathogen, with healthcare populations experiencing substantial intestinal carriage and infection burden. It was found that prolonged hospitalisation, previous antibiotic exposure, invasive devices, diabetes, chronic wounds and increased healthcare contact significantly contribute to colonisation and clinical infection. Furthermore, transmission is sustained through interactions between patients, healthcare workers, medical devices and contaminated environments. Antimicrobial stewardship, genomic surveillance, infection prevention measures and emerging therapies such as β-lactamase inhibitors, bacteriophage therapy and microbiome-based interventions represent important strategies for future control.
Overall, reducing the burden of ESBL-producing E. coli requires coordinated global action integrating surveillance, responsible antimicrobial use, infection prevention and innovation in therapeutic development.

KEYWORDS

ESBL-producing Escherichia coli Antimicrobial resistance Healthcare-associated infections Antimicrobial stewardship One Health

CITATION (Vancouver)

Okechukwu NC, Udeani TK, Okechukwu UC, Ani IE, Ogudu EO, Attah RN. Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthcare Settings: Epidemiology, Risk Factors, Infection Control Strategies and Emerging Treatment Options. Epidemiology and Health Data Insights. 2026;2(5):ehdi060. https://doi.org/10.63946/ehdi/19671
APA
Okechukwu, N. C., Udeani, T. K., Okechukwu, U. C., Ani, I. E., Ogudu, E. O., & Attah, R. N. (2026). Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthcare Settings: Epidemiology, Risk Factors, Infection Control Strategies and Emerging Treatment Options. Epidemiology and Health Data Insights, 2(5), ehdi060. https://doi.org/10.63946/ehdi/19671
Harvard
Okechukwu, N. C., Udeani, T. K., Okechukwu, U. C., Ani, I. E., Ogudu, E. O., and Attah, R. N. (2026). Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthcare Settings: Epidemiology, Risk Factors, Infection Control Strategies and Emerging Treatment Options. Epidemiology and Health Data Insights, 2(5), ehdi060. https://doi.org/10.63946/ehdi/19671
AMA
Okechukwu NC, Udeani TK, Okechukwu UC, Ani IE, Ogudu EO, Attah RN. Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthcare Settings: Epidemiology, Risk Factors, Infection Control Strategies and Emerging Treatment Options. Epidemiology and Health Data Insights. 2026;2(5), ehdi060. https://doi.org/10.63946/ehdi/19671
Chicago
Okechukwu, Nkemdilim Clairelouise, Theophilus Kachi Udeani, Uzoma Chukwunonso Okechukwu, Ifeoma Esther Ani, Emmanuel Ogbonnia Ogudu, and Rita Nnenna Attah. "Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthcare Settings: Epidemiology, Risk Factors, Infection Control Strategies and Emerging Treatment Options". Epidemiology and Health Data Insights 2026 2 no. 5 (2026): ehdi060. https://doi.org/10.63946/ehdi/19671
MLA
Okechukwu, Nkemdilim Clairelouise et al. "Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthcare Settings: Epidemiology, Risk Factors, Infection Control Strategies and Emerging Treatment Options". Epidemiology and Health Data Insights, vol. 2, no. 5, 2026, ehdi060. https://doi.org/10.63946/ehdi/19671

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