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Vancomycin-resistant enterococci (VRE) are a type of bacteria called
enterococci that have developed resistance to many
antibiotics, especially vancomycin. Enterococci
bacteria live in our intestines and on our skin, usually without causing
problems. But if they become resistant to antibiotics, they can cause serious infections, especially in people who are ill or weak. These infections can occur anywhere in the body. Some common sites
include the intestines, the urinary tract, and wounds.
Vancomycin-resistant enterococci infections are treated with
antibiotics, which are the types of medicines normally used to kill bacteria.
VRE infections are more difficult to treat than other infections with
enterococci, because fewer antibiotics can kill the
VRE, like many bacteria, can be spread from one
person to another through casual contact or through contaminated objects. Most
often, VRE infections are spread from the hands of health care workers to a patient in a hospital or
other facility such as a nursing home. VRE infections are not usually spread through the air like the
common cold or flu virus unless you have VRE
pneumonia and are coughing, which is rare.
If you are healthy, your chances of getting a VRE infection are very low. Even if you
have been exposed to VRE, or have VRE in your body, you are not likely to get
an infection. VRE infections typically only occur among people who have
immune systems, such as people who have long-term
illnesses or people who have had major surgery or other medical procedures and
have been treated with multiple antibiotics.
Experts do not know
exactly why some people become infected with VRE and others do not. But they do
know that VRE infections are more likely to develop when antibiotics such as
vancomycin are used often. If you take antibiotics when you do not need them, they may not work when you do need them. Each time you take antibiotics, you are more likely to have some bacteria that the medicine does not kill. These bacteria can change (mutate) so they are harder to kill. Then, the antibiotics that used to kill them no longer work. These bacteria are called antibiotic-resistant bacteria.
of a VRE infection depend on where the infection is. If VRE are causing a wound
infection, that area of your skin may be red or tender. If you have a
urinary tract infection, you may have back pain, a
burning sensation when you urinate, or a need to urinate more often than usual.
Some people with VRE infections have diarrhea, feel weak and sick, or have
fever and chills.
If your doctor suspects that you are infected
with VRE, he or she will send a sample of your infected wound, blood, urine, or
stool to a lab. The lab will grow the bacteria and then test to see which kinds
of antibiotics kill the bacteria. This test may take several days.
get a serious infection with VRE, you may be isolated in a private hospital
room to reduce the chances of spreading the bacteria to others. When your
doctors and nurses are caring for you, they may use extra precautions such as
wearing gloves and gowns.
VRE infections may be difficult to cure
because the bacteria do not respond to many antibiotics. If you have an
infection, your doctor will order antibiotics that may be given by mouth or
into a vein through an IV (intravenously). Sometimes more than one
antibiotic is prescribed to help stop the infection. Part of your treatment may
include sending samples of your blood, urine, or stool to a lab to see if you
still have VRE in your body.
Some people get rid of VRE infections on their
own as their bodies get stronger. This can take a few months or even longer.
Other times, an infection will go away and then come back. Sometimes the
infection will go away, but the bacteria will remain without causing infection.
This is called colonization.
As more antibiotic-resistant bacteria develop and more
cases of VRE infections are documented, hospitals and other health care facilities are
taking extra care to practice infection control, which includes frequent
hand-washing and isolation of patients infected with VRE.
though most healthy people are not at risk for becoming infected or colonized
with VRE, you can take steps to prevent getting a VRE infection.
Other Works Consulted
Centers for Disease Control and Prevention (2011). Vancomycin-resistant enterococci (VRE) in healthcare settings. Available online: http://www.cdc.gov/HAI/organisms/vre/vre.html.
March 10, 2013
E. Gregory Thompson, MD - Internal Medicine & Theresa O'Young, PharmD - Clinical Pharmacy
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