Vancomycin-Resistant Enterococci (VRE)
What is VRE?
Enterococci are bacteria that are normally present in human intestines and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some cases, the bacteria have become resistant to the antibiotic and are called vancomycin-resistant enterococci (VRE). Most VRE infections occur in people in hospitals.
What types of infections does VRE cause?
VRE can live in the human intestines without causing disease (called colonization). Sometimes; however, it can be the cause of urinary tract, bloodstream or wound infections.
Who is at greatest risk of having VRE?
- People who have been previously treated with the antibiotic vancomycin or other antibiotics for long periods of time.
- People who are hospitalized, particularly when they receive antibiotic treatment for long periods of time.
- People with weakened immune systems such as patients in Intensive Care Units, or in cancer or transplant wards.
- People who have undergone surgical procedures such as abdominal or chest surgery.
- People with medical devices that stay in for some time such as urinary catheters or central intravenous (IV) catheters.
What is the treatment for VRE?
People who are colonized (bacteria present, but have no symptoms of an infection) with VRE do not usually need treatment. Most people with VRE infections can be treated with antibiotics other than vancomycin. Laboratory testing of the VRE can determine which antibiotics will work.
How is it spread?
VRE is often passed from person to person by the hands of caregivers. VRE can get onto a caregiver's hands after they have contact with other people with VRE or after contact with contaminated surfaces. VRE can also be spread directly to people after they touch surfaces that are contaminated with VRE. VRE is not spread through the air by coughing or sneezing.
Control measures for VRE:
If someone in a household has VRE, the following are some things that can be done to prevent the spread of VRE:
- Keep hands clean. Hands should also be washed well after using the bathroom and before preparing food. Hands should be cleansed after contact with persons who have VRE by washing with soap and water (when hands are visibly dirty) or using an alcohol-based hand rub.
- Areas of the home such as the bathroom may become contaminated with VRE and should be frequently cleaned.
- Gloves should be worn if there is a possibility of contact with body fluids that may contain VRE, such as stool (feces) or bandages from infected wounds. Hands should always be washed after removing gloves.
- If a person has VRE, he or she should tell health care providers about the infection so that they are aware of the infection or colonization. Health care facilities use special precautions to help prevent the spread of VRE to others like wearing gloves when they examine an infected person and extra cleaning after they leave the room.
How do I know when I don't have VRE anymore?
If you have an infection caused by VRE and treatment is effective, the infection will be gone. Many people who are colonized with VRE remain this way for long periods of time (can be years). Decolonization for people with VRE is not currently recommended. Periodically, you may be screened (tested) for VRE by your health care provider to see if you have gotten rid of the organism without any treatment.
What if I have to go into another health care facility?
If you have to go to another hospital or need to enter a long-term care facility, you need to let the staff know about your past VRE. You may be screened at the time you are admitted to the facility to update your VRE status and allow appropriate precautions to be put into place.
Revised: 2014-07-16