Vancomycin-resistant enterococcus
Vancomycin-resistant enterococcus (VRE) is a mutation of a very common bacterium that is spread easily by direct person-to-person contact. Facilities in more than 40 states have reported VRE, with rates as high as 14% in oncology units of large teaching facilities. Patients most at risk for VRE include:
immunosuppressed patients or those with severe underlying disease
patients with a history of taking vancomycin, third-generation cephalo-sporins, or antibiotics targeted at anaerobic bacteria (such as Clostridium difficile)
patients with indwelling urinary or central venous catheters
elderly patients, especially those with prolonged or repeated hospital admissions
patients with cancer or chronic renal failure
patients undergoing cardiothoracic or intra-abdominal surgery or organ transplants
patients with wounds with an opening to the pelvic or intra-abdominal area, including surgical wounds, burns, and pressure ulcers
patients with enterococcal bacteremia, often associated with endocarditis
patients exposed to contaminated equipment or to a VRE-positive patient.
Causes
VRE enters health care facilities through an infected or colonized patient or a colonized health care worker. VRE is spread through direct contact between the patient and caregiver or between patients. It can also be spread through patient contact with contaminated surfaces such as an overbed table. It’s capable of living for weeks on surfaces. It’s been detected on patient gowns, bed linens, and handrails.
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