Available ICU-focused evidence from India does not support E. coli as the leading ESBL-producing gram-negative organism. The most recent, large ICU datasets cited show Klebsiella pneumoniae is more common than E. coli in ICUs, and multiple bloodstream/hospital studies report Klebsiella as the top ESBL producer. Studies favoring E. coli mainly measure ESBL rates within E. coli or come from non-ICU settings, which cannot establish ICU-wide predominance.