Infection Control: VRE Vancomycin-Resistant Enterococcus

What is VRE?

Enterococcus (EN-ter-oh-KOCK-us) is a type of bacteria, or germ. These bacteria live in the gastrointestinal tract (stomach-bowel tract).

In most cases, enterococcus bacteria cause no infection. But in some people, enterococcus can cause serious infection such as urinary tract infections, wound infections, and blood infections. Vancomycin (van-ko-MY-sin) is an antibiotic often used to treat enterococcus infections. When enterococcus are vancomycin-resistant, most antibiotics cannot kill the bacteria. Vancomycin-resistant enterococcus bacteria are called VRE for short.


What is colonization?

Some people can pick up and carry VRE for weeks and months. These people do not get sick, but they have VRE. This is called colonization (CALL-uh-nih-ZAY-shun). VRE colonization has no symptoms. Bacteria are present but do not cause an infection.

One way to check for colonization is by a test called a “culture.” A special cotton swab is gently rubbed on the skin outside of the rectum. This sample is tested for VRE. The test results are ready in 2 or 3 days.

Who gets VRE?

People most likely to get infected or colonized with VRE are those who:

  • Are seriously ill
  • Are hospitalized for a long time
  • Have a serious disease that harms the body’s ability to fight infection
  • Have taken many antibiotics

Special precautions

People who have VRE can spread it to other people. VRE can also be spread to objects and other surfaces in a room. Hospitals and other health care centers use special precautions (pre-CAW-shuns) to help prevent the spread of VRE. Patients with VRE are placed on special precautions. This means:

  • Patients have a private room if one is available. If a private room is not available, 2 people with VRE may share a room.
  • Staff and visitors should wear a gown and gloves to enter the isolation room.
  • Before entering and leaving the room, all patients, staff, and visitors should wash their hands with soap and water or waterless hand cleaner.
  • Patients on special precautions should stay in their room when possible. If they have to leave the room, patients must wash their hands well and may need to wear protective clothing. This practice protects other patients, staff, and visitors.
  • Limit the movement and transport of the patient from the room to essential purposes only.  Generally, patients in Contact Precautions should not go to common areas on the nursing unit or within the facility.
  • Some health care equipment may be kept in your room for your use only.
  • Personal items in your room can be contaminated. You should have as few personal items in the room as needed. Such items should be stored in drawers and closets to keep surfaces free to be cleaned.
  • During repeat visits to the health care facility, special precautions will be used

When you go home

When patients with VRE are discharged, they can return to their normal routine. They may go out in public.

  • At home, good hand washing by every person in the house is important.
  • Laundry and dishes can be done as usual.
  • No special cleaning is required.
  • Patients should tell anyone caring for them that they have VRE. This includes home health providers, nurses, therapists, doctors’ office staff, and rescue squads.

NOTE: If the individual has a draining wound or uncontrolled secretions or excretions, special precautions should be taken.

Questions

If you have any questions about VRE, please ask your nurse or doctor. You may also contact the hospital’s Infection Control Department. Tell your nurse that you want to do so.

Revised August 2013

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