Vancomycin-Resistant Enterococcus (VRE)

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KEY POINTS

• Enterococcus is bacteria that commonly lives in the body and usually does not cause infections. However, some enterococcus bacteria can change and become resistant to vancomycin, which is an antibiotic often used to treat it. This is called vancomycin-resistant enterococcus (VRE).
• VRE is treated with antibiotics that lab tests show will work against the bacteria. If the IV line or a catheter you have been using is infected, it will be removed.
• If you are taking an antibiotic, take the medicine for as long as your healthcare provider prescribes, even if you feel better before you finish all the antibiotic medicine.

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What is vancomycin-resistant enterococcus (VRE)?

Enterococcus is a type of bacteria. It commonly lives in the intestines and in the female genital organs. Most of the time it does not cause infections. When it does cause an infection, vancomycin is an antibiotic often used to treat it. However, some enterococcus bacteria can change and become resistant to vancomycin. This means the antibiotic is not able to kill the bacteria and cure the infection. These bacteria are called vancomycin-resistant enterococcus, or VRE.

What is the cause?

You are more likely to have a VRE infection if:

• You have been treated with antibiotics for a long time
• You have been in the hospital often or for a long time
• You have a weakened immune system. The immune system is your body’s defense against infection. Things like severe illness, cancer, or an organ transplant can weaken your immune system.
• You have had major chest or abdominal surgery
• You have a catheter or an IV line in your body for several weeks
• You are on dialysis
• You have a serious medical problem, such as diabetes, kidney disease, or a skin problem that makes it easy for you to get skin infections

What are the symptoms?

The symptoms of VRE infection depend on where the infection is. You might have the infection in your urinary tract, skin, bowel, or blood.

Symptoms may include:

• Fever and chills
• Sometimes headache or body aches
• Redness, swelling, or drainage of pus from pockets of infection or any wounds, including where an IV goes into your skin
• Confusion

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You will have urine and blood tests to look for signs of infection. A sample of blood or fluid from a wound or IV site may be sent to the lab and tested. The test, called a culture, also shows which medicines are best for treating the bacteria. If you have a bacterial infection, it may take 2 to 3 days to find out what kind of germ is causing it. Knowing what germ is causing the infection and which medicines work best to treat it helps your provider choose the right medicine.

How is it treated?

VRE is treated with antibiotics that lab tests show will work against the bacteria.

If the IV line or a catheter you have been using is infected, it will be removed.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider.

• If you are taking an antibiotic, take the medicine for as long as your healthcare provider prescribes, even if you feel better. If you stop taking the medicine too soon, you may not kill all of the bacteria and you may get sick again.
• Get plenty of rest.
• Ask your provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent the spread of VRE?

Make sure that all healthcare providers caring for you clean their hands with soap and water or an alcohol-based hand rub before and after caring for you. If you do not see them clean their hands, ask them to do so.

Also remind everyone who enters your hospital room, whether family or friends, to clean their hands. This is especially important before and after touching part of your body or anything that has been in contact with you. The VRE can live on surfaces such as bedrails for hours to days.

When you go home from the hospital, some things you and your family and friends can do to prevent the spread of VRE are:

• Wash your hands with soap and running water often and especially after using the restroom, coughing, sneezing, or blowing your nose. Also, wash your hands before preparing any food, eating, or touching your mouth, nose, or eyes.
• Wash your hands well with soap and water after caring for any wounds or touching anything with body fluids on it, even when you have used gloves.
• Put gloves, tissues, or other waste items soiled with blood or other body fluids in a separate bag from your regular trash. The bag should be sealed and leak-proof. For example, use 2 bags, putting one inside the other. Follow your local health department's instructions for disposing of waste products.
• If you have VRE, be sure to tell anyone who is caring for you or giving you treatment. Healthcare providers must use special precautions to help prevent the spread of VRE to others.