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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

VRE infections can be cured in most patients, and the outcome is often more dependent on the underlying disease than on the infecting organism. The duration of treatment depends on the site of infection. For example, heart-valve infections may require six weeks of antibiotic therapy. Although the heart valve or other infected site infection is cured of VRE infection, many patients may be still colonized with the organism on mucosal surfaces.

The best way to prevent infection is to prevent transmission. This means that hospitals and care facilities must pay meticulous attention to infection-control guidelines to reduce the spread of VRE from patient to patient. Individuals can reduce their risk by washing hands after using the bathroom and before and after touching the mouth or nose. Minimizing the use of intravenous catheters, especially central lines, reduces the risk of VRE sepsis. Similarly, the use of urinary catheters should be minimized and catheters should be removed promptly when no longer needed. Finally, antibiotics should be used only for appropriate indications. Antibiotics are ineffective against viruses and the common cold.

Caretakers of infected patients should follow good hand hygiene principles. This means washing hands or using alcohol disinfectants on hands before and after touching the patient or objects in the patient's environment. If there is visible soiling of the hands, soap and water should be used rather than alcohol-based disinfectants. If the patient is incontinent of stool or urine, gloves may be used to help clean the bed or the patient. Gloves are not a substitute for hand hygiene. Simple household disinfectants are effective against VRE and can be used to clean the environment. A 10% bleach solution may also be used.

Hospitals will take additional precautions. Once a patient is known to harbor VRE, whether colonized or infected, the patient will be placed in "contact precautions," usually in a private room. People entering the room will wear a cloth or paper gown over their clothes and use gloves. Again, hand hygiene is critical to reduce spread of the organism.