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Facts About...

VANCOMYCIN RESISTANT ENTEROCOCCUS (VRE)


What is it?

Vancomycin sensitive enterococcus is part of everyone’s normal bowel bacteria. This is normal and is called colonization. Vancomycin resistant enterococcus (VRE) is a type of enterococcus that has developed resistance to many commonly used antibiotics, especially an antibiotic called vancomycin.

How is it spread?

VRE is spread primarily by direct contact with unwashed hands or gloves after direct contact with someone or the contaminated environment. VRE is very hardy and will easily survive in the environment. Handling items such as doorknobs, bedpans, and toilet rims that have been contaminated with VRE can also spread the germ. Bacteria can rapidly colonize the bowel of other susceptible individuals after ingestion. Good handwashing and environmental cleaning are essential to prevent the spread of VRE.

How is it treated?

People colonized with VRE generally do not receive treatment. People who are infected with VRE are difficult to treat and require a careful selection of antibiotics. A concern is that the resistance pattern of VRE can be transferred to other bacteria such as Methicillin Resistant Staphylococcus aureus (MRSA); MRSA associated infections are normally treated with vancomycin. If MRSA becomes resistant to vancomycin, it leaves limited options for treatment.

Are signs and symptoms of VRE always evident?

There are no signs or symptoms associated with colonization involving VRE. However, people who are elderly, sick or immunodeficient may develop a VRE infection, such as in the blood, urine or wounds, causing sepsis, urinary tract infections, and/or abscesses. People most at risk are those who are very ill and are in the intensive care unit of a hospital.

How can I protect myself?

Good handwashing and environmental cleaning can prevent the spread of VRE. The risk for healthy people in the community is minimal. However, with inadequate handwashing health care workers can acquire and spread VRE. Over days to months, the normal bowel bacteria eventually eliminate the VRE without treatment. To prevent antibiotic resistance from developing, antibiotics should be used carefully and taken as prescribed.

More information can be obtained from

Durham Region Health Department, Environmental Help Line 905-723-3818 or 1-888-777-9613

April 22, 2013