Vancomycin-Resistant Enterococcus (VRE) Infections

What is a vancomycin-resistant enterococcus (VRE) infection?

Vancomycin-resistant enterococcus (VRE) is a type of bacteria that is resistant to many antibiotics, including vancomycin.

These bacteria live in our intestines and on our skin. They usually don't cause problems. But sometimes they cause infection. This can occur anywhere in the body. Some common sites include the intestines, the urinary tract, and wounds.

For some people, especially those who have a weakened immune system or other health conditions, these infections can become serious.

VRE can spread from person to person. It is commonly spread from the hands of someone who has VRE. This could be anyone in a health care setting or in the community.

If you are healthy, your chances of getting VRE are very low.

How does it spread?

VRE, like many bacteria, can be spread from one person to another through contact or through objects that have the bacteria on them. Most often, people are exposed to VRE infections in health care settings, such as a hospital or other facility like 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.

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 weakened immune systems, such as people who have long-term health conditions 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.

What are the symptoms?

Symptoms of a VRE infection depend on where the infection is:

• If VRE is in a wound, that area of your skin may be red or tender.
• If VRE is in the urinary tract, you may have back pain, a burning sensation when you urinate, or a need to urinate more often than usual.

You may also:

• Have diarrhea.
• Feel weak and sick.
• Have a fever and chills.

How is it diagnosed?

If your doctor thinks that you may be infected with VRE, a sample of your infected wound, blood, urine, or stool will be sent 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.

How is it treated?

• Most VRE infections are treated with antibiotics.
  • Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • VRE infections may be hard to cure because they become resistant to some antibiotics.
  • You may need more than one antibiotic to stop the infection.
• If you get a serious infection with VRE, you may have to stay in the hospital for treatment. While there, you may be kept apart from others to reduce the chances of spreading the bacteria.
• You may have samples of your blood, urine, or stool sent to a lab. This checks to see if you still have VRE in your body.
• If you don't have symptoms, your doctor may not give you antibiotics. This may help keep VRE from becoming more resistant to antibiotics.

How can you help prevent it?

• Practice good hygiene.
  • Wash your hands often and thoroughly with soap and clean, running water. You can also use an alcohol-based hand sanitizer. Hand-washing is the best way to avoid spreading germs.
  • Keep cuts and scrapes clean and covered with a bandage. Avoid contact with other people's wounds or bandages.
  • Do not share personal items such as towels or razors.
  • Keep your home, work, and other spaces clean by using a disinfectant to wipe surfaces you touch a lot. These include countertops, doorknobs, and light switches.
• Be smart about using antibiotics. Know that these medicines can help treat bacterial infections. They can't cure viral infections. Always ask your doctor if antibiotics are the best treatment. And don't pressure your doctor to prescribe them when the doctor thinks they won't help you get better.
• If you are in the hospital, remind your doctors and nurses to wash their hands before they touch you.