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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

Research on VRE is focused on several areas:

• Improving infection-control practices to reduce spread of VRE in health-care environments



• The development of new antibiotics to treat VRE



• The development of urinary catheters and intravenous catheters that are more resistant to infection



• Basic research aimed at improving our understanding of the bacteria itself and how vancomycin-resistance is transferred from species to species

"Vancomycin-Resistant Enterococci in Healthcare Settings," Centers for Disease Control and Prevention
http://www.cdc.gov/HAI/organisms/vre/
vre.html

"Enterococcal Infections: Treatment & Medication," eMedicine.com
http://emedicine.medscape.com/article/
216993-treatment

• Enterococci are bacteria that commonly live in the bowel and are usually resistant to many antibiotics. VRE are enterococci that have become resistant to the antibiotic vancomycin.
• There are only a few antibiotics that are able to treat VRE infections. However, newer antibiotics are being developed.
• People can be colonized with VRE, meaning that the bacteria are living harmlessly in the body.
• VRE causes infection when it invades the bloodstream or spreads locally. It can also be introduced directly into a wound.
• Infection is more likely in patients with chronic diseases like diabetes or patients who have recently received antibiotics. It is also more common in patients with indwelling devices like intravenous lines or urinary catheters and those with compromised immune systems.
• VRE can cause many types of infections (for example, bloodstream infection [sepsis], urinary infection, abscesses, wound infections, pneumonia, heart infections [endocarditis] or meningitis).
• To avoid spreading VRE from person to person, it is important to wash or decontaminate hands frequently, including before and after touching the patient or his/her environment. In the hospital, staff will also wear gowns and gloves when caring for a person with VRE.
• The risk of VRE infection can be reduced by minimizing the use of indwelling devices such as intravenous lines and urinary catheters. The risk is also reduced by eliminating inappropriate use of antibiotics.

REFERENCE:

Lin, M.Y., and M.K. Hayden. "Methicillin-Resistant Staphylococcus Aureus and Vancomycin-Resistant Enterococcus: Recognition and Prevention in Intensive Care Units." Crit Care Med. 38.8 Aug. 2010: S335-44.