Vancomycin Resistant Enterococcus (VRE)

What is VRE?

VRE stands for Vancomycin Resistant Enterococcus. The Enterococcus is a bacterium (germ) that everyone has in their bowel. Vancomycin is one of the antibiotics used to treat infections caused by the Enterococcus germ. Sometimes this germ develops resistance to Vancomycin. When this occurs, the infection can no longer be treated by Vancomycin.

Healthy people can carry VRE with no ill effects or signs and symptoms. This is called colonisation. This is the most common situation with VRE. People who are colonised do not need treatment.

In hospitals VRE can cause infections in a small minority of very sick patients whose ability to fight off infections has been lowered. When this occurs, it is more difficult to treat these patients, although there are still several antibiotics to which the VRE is susceptible.

Where does VRE come from?

VRE occurs the bowels of some people who have taken antibiotics, often at very low or undetectable levels. When people receive specific antibiotics such as vancomycin, VRE may be selected for and become detectable. Excessive use of antibiotics for minor infections, such as the common cold, where antibiotics are not required, is likely to be a major contributor to the emergence of VRE. In some parts of the world, the emergence of VRE has also been linked to use of antibiotics in animal husbandry.

How is VRE spread?

VRE is spread mainly by direct contact from another colonised person or from contact with unwashed hands or a contaminated surface. It is not spread through coughing or sneezing.

When are hospital patients tested?

As the VRE germ lives in the bowel, testing for VRE involves taking a faeces sample or a rectal swab. Unfortunately, the VRE germ is difficult to detect and for this reason it may be necessary to take several samples. Pending the outcome of results, which will take several days to finalise, nursing staff will take special precautions such as the wearing of a gown and gloves. A card alerting the staff to take these precautions may be placed on the door. Visitors will not need to take any special precautions apart from washing their hands on leaving a patient's room.

What happens if a VRE test is positive?

Being positive for VRE does not mean being infected. Most patients are carriers only and have no signs or symptoms. There will be no change to the quality of the planned treatment and care given. A patient may be required to remain in a single room or share accommodation with other VRE positive patients. This could mean being moved to another ward. Staff will continue to take the special precautions already mentioned. These measures are required to prevent spread to very sick patients.

Will being VRE positive affect family or friends?

No, it will not affect family and friends. While VRE is a risk for very sick patients in hospital, it is not a threat to normal healthy people.

What happens when a patient goes home?

After returning home, patients should continue normal hygiene practices - such as handwashing after going to the toilet and before eating. It is not necessary to take any special precautions.

 

Adapted from "VRE Information for Patients" guidelines, Coffs Harbour Base Hospital, NSW.

 

Further information

For further information please visit the Vancomycin Resistant Enterococcus Factsheet on the Department of Health and Ageing website.

 

 

 

 

 

 

 

Last Reviewed: September 2009