Vancomycin-resistant Enterococci (VRE)
Enterococci are bacteria (germs) that commonly live in the gastrointestinal tract (bowels) of most people (this is called colonisation) without causing illness.
Vancomycin is an antibiotic used to treat infections caused by enterococci. When enterococci become resistant to vancomycin (meaning the antibiotics are no longer effective), they are called vancomycin-resistant enterococci or VRE.
Most of the time VRE do not cause any problems and those who are colonised with VRE do not look or feel different to anyone else. However, sometimes VRE can get into other parts of the body and cause an infection.
There are other antibiotics that can be used to treat VRE infections.
Who is most at risk of getting VRE infections?
People whose ability to fight infections is low, such as:
- people with cancer
- those receiving dialysis
- people in an intensive care unit
- people who have had transplants.
How is VRE spread?
VRE can be spread from person to person through direct contact with an infected or colonised person.
This is either directly from the hands of another person or indirectly from environmental surfaces or medical equipment that have become contaminated.
It is not spread through the air or by coughing or sneezing.
Signs and symptoms
There is no specific ‘VRE disease’.
The symptoms that develop with VRE infection are the ones you would get with any other bacterial infection such as:
- fever
- feeling generally unwell
- rapid pulse rate
- redness, swelling, pain or heat at a specific site
In some cases VRE can enter the bloodstream, from either an existing infection such as an abscess or urinary tract infection or from a medical device such as a urinary catheter or intravenous catheter.
Symptoms of bloodstream infection are also not specific to VRE and can be the same as for other bacteria. Typically, signs and symptoms can include fever, shivering, and low blood pressure.
How do I know I have VRE?
People carrying VRE in their bowel or other body sites show no signs or symptoms and it is impossible to tell if a person has VRE by looking at them.
If infection is suspected then a doctor will take a swab or specimen of, for example, blood, or wound, or urine or sputum and send it to the laboratory for testing.
Treatment of VRE infections
There is no vaccination available to prevent you from acquiring VRE or treatment to eliminate VRE from your body. People colonised with VRE do not need to have any treatment or antibiotics.
If the VRE are causing infection, there are still some antibiotics that can be used.
What happens if you have VRE?
If VRE is found in a specimen taken from you while you are in hospital, your healthcare team will continue to provide the same level of care. However, some extra precautions will be taken:
- You will be moved to a single room.
- Everyone, including you and your visitors, will need to wash their hands or use an alcohol-based hand rub before entering or leaving your room.
- A sign will be placed on your door to remind others of the precautions they need to follow, for example, to wear a gown and gloves when providing care.
- An alert will be placed against your name in the hospital computer system that can be seen by all the metropolitan public hospitals in WA. This alerts staff at the time of future admissions that extra precautions are required.
- As there is no method for this information to be shared with WA country or private hospitals, residential care facilities or hospitals outside of WA, it is important you advise these health providers that you have acquired a VRE.
What about my family and visitors?
Your family and friends can visit you but to prevent the spread of VRE to other patients or the environment, it is important that all visitors:
- always follow hand hygiene practices before entering and leaving your room
- do not eat or drink in your room
- do not use your hospital bathroom.
When you return home
Good hand hygiene will help prevent your family and friends from getting VRE. You should always perform hand hygiene by washing your hands with soap and water:
- after using the bathroom
- before and after eating
- if you touch any wounds or medical devices that you may have, for example a urinary catheter or wound drain.
VRE can survive for long periods on environmental surfaces, for example toilets, table tops and chairs, so it is important to regularly clean your household. Your clothing can be washed in the usual manner, along with the rest of the household laundry.
If you go to another healthcare facility, visit another doctor or have home care services, you should tell them that you have a VRE.
How can the spread of VRE be prevented?
Early detection of people who carry VRE is essential to stop any spread. This is why we screen for VRE in WA hospitals.
If someone has a history of being in a hospital or residential care facility outside of WA in the last 12 months, a specimen to screen for VRE (either a stool sample or a rectal swab) will be taken from them when they are admitted to hospital.
More Information
- If you are in hospital, you can ask to speak to the infection prevention control nurse.
- See your doctor.
- Ring healthdirect Australia on 1800 022 222.
Remember
- Bacteria known as vancomycin-resistant enterococci (VRE) are resistant to some powerful antibiotics.
- VRE are usually spread from person to person through contact with infected people or people who carry the bacteria without it causing infection within themselves.
- Hand hygiene is a simple but very effective measure that stops the spread of germs.
Acknowledgements
Public Health
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.