Vancomycin-Resistant Enterococci

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

How are vancomycin-resistant enterococci (VRE) spread?

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.

What are 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.

What is the incubation period and contagious period for VRE?

The incubation period for VRE is not well documented, especially in those patients who develop VRE from taking antibiotics and because some individuals may be carriers of VRE and become infected after some problem that decreases their immune responses or damages their mucus membranes. Estimates of the incubation period vary from days to weeks or even longer, and the contagious period is estimated to be as long as VRE are shed from the patient.

Medically Reviewed by a Doctor on 8/12/2016

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