Vancomycin-Resistant Enterococcus

Enterococci are bacteria that are normally present in the intestines and in the female genital tract and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is sometimes used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and are called Vancomycin-resistant enterococci (VRE). Most VRE infections occur in hospital settings.

VRE can live in the intestines and female genital tract without causing disease. However, sometimes they cause urinary tract infections, blood stream infections and wound infections.

Certain categories of people are at higher risk of becoming infected with VRE. These include people who:

• Have previously been treated with vancomycin or combinations of other antibiotics
• Are in Intensive Care Units or in cancer or transplant units
• Have undergone surgical procedures such as abdominal or chest surgery
• Have medical devices that remain in for a long time, such as urinary catheters or central venous catheters
• Have weakened immune systems

Yes. VRE is usually passed to others by contact with stool, urine or blood containing VRE. It can also be spread on the hands of healthcare providers or on contaminated environmental surfaces or equipment. VRE is usually not spread through casual contact such as touching or hugging. VRE is not spread through the air by coughing or sneezing.

While you are in the hospital, you will notice staff taking special precautions. These precautions are taken to prevent the spread of VRE to others. Many of our patients are in a weakened state and are susceptible to infection. Staff caring for you will wear gloves and gowns while in your room. A sign reading “Contact Precautions” is placed at the entrance to the room to alert providers to take special precautions.

Because VRE can be spread on the hands, your health care providers will clean their hands with either alcohol hand rub or soap and water before and after they care for you. Please feel free to ask your health care providers if they cleaned their hands and remind them to do so.

You may leave your room but you must take some precautions. Wash your hands and put on a clean gown or a clean robe. When you are out of the room, please do not touch other patients or items in the environment.

You may have visitors. Your visitors will be asked to wear gloves while in your room. Your visitors should wash their hands before leaving your room. Hand hygiene is the best way to prevent the spread of VRE. If your visitors take these precautions, it is very unlikely that they will get VRE. If you have concerns about whether someone should visit, please talk to your doctor or nurse.

Once you return home, both you and your family members should wash your hands as part of routine hygiene. In most ways, this is no different from the hand washing most people practice to stay healthy. For example, wash before and after eating and after using the toilet. Wash your hands well with soap and water, rinse well, and dry completely. Surfaces in bathrooms, kitchens, and other areas should be cleaned on a regular basis using diluted household bleach.

If family members provide personal care to you while you have an infection with VRE, they should take precautions and wear gloves and wash their hands afterward. If clothes or bedding become soiled, wash them in the washing machine with hot soapy water.

Most VRE infections can be treated with antibiotics other than vancomycin. The treatment for VRE is determined by laboratory testing to see which antibiotics are effective. For people who get VRE infections and have urinary catheters, removal of the catheter when it is no longer needed can help to get rid of the infection. People who are colonized (bacteria are present but have no symptoms of infection) with VRE do not usually need treatment.

Anyone providing care for you needs to know if you have VRE. This includes doctors, nurses, and anyone who may be providing care in your home. This helps to avoid spread and to provide you with the best treatment.