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Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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In this Article

• What are vancomycin-resistant enterococci (VRE)?
• What causes a vancomycin-resistant enterococcal (VRE) infection?
• What are risk factors for vancomycin-resistant enterococci (VRE) infections?
• How are vancomycin-resistant enterococci (VRE) transmitted?
• What are the symptoms and signs of a vancomycin-resistant enterococcal (VRE) infection?
• How is a vancomycin-resistant enterococcal (VRE) infection diagnosed?
• What is the treatment for a vancomycin-resistant enterococcal (VRE) infection?
• What is the prognosis of a vancomycin-resistant enterococcal (VRE) infection?
• Can vancomycin-resistant enterococci (VRE) infections be prevented?
• What precautions should people take when tending to someone with a vancomycin-resistant enterococcal infection?
• What research is being done on vancomycin-resistant enterococci (VRE)?
• Where can people find more information on vancomycin-resistant enterococci (VRE) infections?
• Vancomycin-Resistant Enterococci (VRE) At A Glance
• Patient Comments: Vancomycin Resistant Enterococci (VRE) - Treatments
• Patient Comments: Vancomycin - Symptoms
• Vancomycin-Resistant Enterococci (VRE) Index

The healthy bowel harbors more than 400 different species of bacteria which compete with each other and help keep any one organism from overgrowing. However, if a patient takes antibiotics, some bacterial species are killed off and the balance among the bacteria is disrupted. In this case, a single species like VRE may increase to the point where it can invade the bloodstream or cause a local infection. Thus, prior use of antibiotics is a risk factor for infection with VRE. Other risk factors include having a compromised immune system, cancer, a chronic disease like diabetes, or kidney failure. Infection is also more likely if there is a small break in the mucosal membrane (lining) of the bowel or if the patient undergoes a gastrointestinal surgery or procedure. Indwelling devices, such as urinary catheters or intravenous lines, increase the risk of infection because they disrupt the normal mucosal or skin barriers and provide a type of artificial reef on which the organisms can grow.

VRE can be transmitted from person to person, especially in a hospital or chronic-care facility. Microscopic amounts of fecal material from an infected or colonized patient can contaminate the hospital environment and be spread on the hands of health-care personnel. Patients who have VRE may inadvertently contaminate their beds and bathrooms. If the environment is not adequately cleaned, the next patient in the room may be at risk.