Vancomycin-Resistant Enterococci (VRE) (cont.)

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What are the risk factors for vancomycin-resistant enterococci (VRE) infections?

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 at which it can invade the bloodstream or cause a local infection. Thus, prior use of antibiotics, especially vancomycin, 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 in patients undergoing 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. If a person is colonized or is hospitalized, their risk for infection with VRE increases.

How are vancomycin-resistant enterococci (VRE) transmitted?

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 or by contamination of surfaces such as bedding or clothing. Patients who have VRE may inadvertently contaminate their beds and bathrooms. If the environment is not adequately cleaned, the next patient (or visitor) in the room may be at risk. VRE infections are not spread by coughing or sneezing.

Medically Reviewed by a Doctor on 1/22/2014

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