Vancomycin-resistant enterococci - hospital: MedlinePlus Medical Encyclopedia

P Enterococcus is a germ (bacteria). It normally lives in the intestines and in the female genital tract.
P Most of the time, it does not cause problems. But Enterococcus can cause an infection if it gets into the urinary tract, bloodstream, or skin wounds.
P Vancomycin is an antibiotic that is often used to treat these infections. Antibiotics are medicines that are used to kill bacteria.
P Enterococcus germs that vancomycin does not kill are called vancomycin-resistant enterococci (VRE). VRE can be hard to treat because there are fewer antibiotics that can fight the bacteria. Most VRE infections occur in hospitals.

T Who is Most at Risk for VRE?
P VRE infections are more common in people who:
- Are in the hospital, especially if they are taking antibiotics for a long time
- Are older
- Have long-term illnesses or weak immune systems
- Have been treated before with vancomycin, or other antibiotics for a long time
- Have been in intensive care units (ICUs)
- Have been in cancer or transplant units
- Have had major surgery
- Have catheters to drain urine or intravenous (IV) catheters that stay in for a long time

T Preventing the Spread of VRE in the Hospital
P VRE can get onto the hands by touching a person who has VRE or by touching a surface that is contaminated with VRE. The bacteria then spread from one person to another by touch.
P The best way to prevent the spread of VRE is for everyone to keep their hands clean.
- Hospital staff and health care providers must wash with soap and water or an alcohol-based hand sanitizer before and after caring for every patient.
- Patients should wash their hands if they move around the room or the hospital.
- Visitors also need to take steps to prevent spreading germs.
P Urinary catheters or IV tubing are changed on a regular basis to minimize the risk of VRE infections.
P Patients infected with VRE may be placed in a single room or be in a semi-private room with another patient with VRE. This prevents the spread of germs among hospital staff, other patients, and visitors. Staff and providers may need to:
- Use proper garments, such as gowns and gloves when entering an infected patient's room
- Wear a mask when there is a chance of splashing bodily fluids

T Treating VRE Infections
P Often, other antibiotics besides vancomycin can be used to treat most VRE infections. Lab tests will tell which antibiotics will kill the germ.
P Patients with the Enterococcus germ who do not have symptoms of an infection DO NOT need treatment.

T Alternative Names
P Super-bugs; VRE; Gastroenteritis - VRE; Colitis - VRE; Hospital acquired infection - VRE

T References
P Arias CA, Murray BE. Enterococcus species, Streptococcus gallolyticus group, and Leuconostoc species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 202.
P Rubenstein E, Keynan Y. Vancomycin-resistant enterococci. Crit Care Clin. 2013;29(4):841-852. PMID: 24094380 www.ncbi.nlm.nih.gov/pubmed/24094380.

T Review Date 3/13/2016
P Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

T Related MedlinePlus Health Topics
- Antibiotic Resistance

