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Vancomycin resistant enterococci

Enterococcus is a germ (bacterium). It normally lives in the intestines and in the female genital tract.

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.

Vancomycin is the antibiotic that is often used to treat these infections. Antibiotics are medicines that are used to kill some germs called bacteria.

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.

Who Is at Most Risk for VRE?

VRE infections are more common in patients who:

  • Are in the hospital, especially if they are taking antibiotics for a long time
  • Are older or who have long-term illnesses and weak immune systems
  • Have been treated before with vancomycin or other antibiotics for a long time
  • Have been in intensive care units or cancer or transplant units
  • Have had major surgery
Have catheters to drain urine or intravenous (IV) catheters that stay in for a long time

Preventing the Spread of VRE in the Hospital

VRE can get onto hands by touching a person who has VRE or by touching a surface that has VRE on it. The bacteria then spread from one person to another by touch.

The best way to prevent the spread of VRE is for everyone to keep their hands clean.

Urinary catheters or IV tubing are changed on a regular basis to minimize the risk of VRE infections.

Patients infected with VRE may be placed in a single room.This prevents the spread of germs among hospital staff, the patient, and visitors. Staff and health care providers may need to:

  • Use proper garments, such as a gown and gloves when entering the patient’s room
  • Wear a mask when there is a chance of splashing of bodily fluids

Treating VRE Infections

Often, other antibiotics besides vancomycin can be used to treat most VRE infections. Lab tests will tell which antibiotics will kill the germ.

Patients with the enterococcus germ who do not have symptoms of an infection do not need treatment.

Alternate Names

Super-bugs; VRE

Update Date: 4/9/2012

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. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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