Vancomycin-Resistant Enterococcus (VRE)
Last Reviewed: November 2011
What is VRE?
Enterococci are bacteria that are naturally present in the intestinal tract of all people. Vancomycin is an antibiotic to which some strains of enterococci have become resistant. These resistant strains are referred to as VRE.
Are VRE infections serious?
In general, enterococci are not very harmful or virulent. This applies to both antibiotic-resistant as well as nonresistant or sensitive strains. However, when VRE infects the urinary tract, surgical wounds or the bloodstream of hospitalized patients, it may be difficult to treat and, occasionally, may be life threatening. New antibiotics to treat VRE are under development.
Who gets VRE?
Serious VRE infections usually occur in hospitalized patients with serious underlying illnesses such as cancer, blood disorders, kidney disease or immune deficiencies. People in good health are not at risk of infection, but health care workers may play a role in transmitting the organism, if careful hand washing and other infection control precautions are not practiced.
How is VRE spread?
VRE is usually spread by direct contact with hands, environmental surfaces or medical equipment that has been contaminated by the feces of an infected person.
What type of prevention is needed when caring for patients with VRE?
When providing care in a private home, hospital or nursing home, health care workers should use disposable gloves and wash their hands with soap after caring for a person with VRE. A disposable gown should also be used if the type of care involves washing or turning the patient, or changing diapers. Routine cleaning of bed rails, toilets and commodes with a bleach solution or hospital-grade disinfectant is also important. In the hospital setting, equipment such as rectal thermometers and blood pressure cuffs should be assigned solely to the infected patient.
Are special precautions needed for home care of patients with VRE?
Standard precautions including hand washing and gloving should be followed. Otherwise, healthy household members are not at risk of VRE infection. Dishes and utensils can be washed in a dishwasher or with warm soapy water and rinsed. Bed linen and clothing can be washed in a washing machine using a standard detergent for clothing.
Can nursing homes or hospitals refuse to accept patients with VRE?
No. Such discrimination is unnecessary and may be illegal. Nursing homes and hospitals are expected to follow state and federal guidelines for VRE patients which include standard precautions and proper room assignment.
Where can I get further information on VRE?
For general information, contact the New York State Department of Health, Bureau of Communicable Disease Control, at (518) 473-4439. Patients in hospitals or nursing homes may contact the facility's infection control nurse.