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Aim: The aim of the current study is to determine the incidence of extended spectrum beta lactamase producing Enterobacteriaceae (ESBL) in rectal swab samples of patients who are under hemodialysis treatment and to determine the risk factors related to ESBL carrier state. Material and Methods: Seventy-eight patients (43 female (mean age: 46± 3.6 years) and 35 male (mean age: 55± 4.3 years) who are under hemodialysis treatment due to chronic renal failure were included to the study. The risk factors related to the ESBL rectal carriage in the patients (gender, mean age, duration of hemodialysis, and antibiotic use during last 6 months) were investigated. P⩽ 0.05 was accepted as statistically significant. Results: While rectal carriage of ESBL-positive (producing) Enterobacteriaceae species was detected by double disc synergy test in 30 (38%) of a total of 78 patients included in the study, ESBL positivity was found in 26 (33.3%) of patients with ESBL chromogenic agar medium. ESBL-positive E.coli was isolated in 20 (66.6%) of the hemodialysis patients and ESBL positive Klebsiella species was isolated in seven (23.3%) cases, and ESBL-positive Proteus species was isolated in three (10%) cases. While there was a history of antibiotic use within last six months in 20 (66.7%) of the patients in which ESBLpositive Enterobacteriaceae spp. was detected, there was a history of antibiotic use within last six months in five (10.4%) ESBL-negative patients. A statistically significant correlation was found between rectal carriage of ESBL positive Enterobacteriaceae spp. and antibiotic use within last six months in hemodialysis patients (p<0.001). Conclusion: Antibiotic use within the last six months is an important risk factor for rectal carrier of ESBL-positive Enterobacteriaceae spp. in hemodialysis patients and it increases the risk of carrier state approximately 17-fold. Therefore, unnecessary antibiotic use should be avoided in hemodialysis patients for the prevention of infections caused by ESBL-positive Enterobacteriaceae spp. [ABSTRACT FROM AUTHOR]