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What are vancomycin-resistant enterococci?

Image of human digestive system

Enterococci are bacteria (germs) that live in people’s gastrointestinal tract (the stomach and intestines).  These germs are also found in the environment.  Most healthy people do not get sick from this germ; however, when they do, it is often treated with antibiotics (i.e. medications that fight bacteria).  Vancomycin-resistant enterococci (VRE) are bacteria that cannot be killed by a type of antibiotic called vancomycin.

Most healthy people can carry the bacteria without it causing them any harm; this is known as “colonization”.  When the bacteria cause symptoms and make people sick, we call it an infection. 

What are the symptoms of VRE?

When people get the VRE bacteria, we do not know how long it takes before symptoms start to show.   Symptoms vary depending on where in the body the infection is.  It can cause a urinary tract infection (an infection of the place where pee is made and removed from the body).  It can also infect the blood, which is known as “bacteremia”   

How does VRE spread?

VRE spread through the feces (poop) of people who are colonized or infected with VRE.  It can be spread directly or indirectly from person to person by:

  • Touching contaminated surfaces that have feces on it, such as toilets, doorknobs, or furniture.  The germ can live on surfaces for long periods of time and are difficult to kill. 
  • Unclean hands can carry the germ from person to person.

People most at risk for colonization or infection are those who stay in the hospital and other health care facilities or people who do not have a strong immune system (body’s ability to fight off infections). Healthcare workers can spread it to their patients if they do not clean their hands properly.

How long is it contagious?

It is unknown how long VRE is contagious.

How are VRE treated?

Treatment of people colonized with VRE is not recommended.

For those who have a VRE infection, your health care provider might prescribe medications, such as antibiotics other than vancomycin.  Make sure to take antibiotics as prescribed to kill all of the bacteria.

What if I have been exposed to someone who has VRE?

Close contacts of someone who has VRE are at a higher risk of getting VRE themselves.  People most at risk include:

  • Patients/residents who are roommates or have been in physical contact with a person who is later found to have VRE
  • Patients/residents staying in a room previously occupied by someone who has VRE, if the room was not cleaned properly

How are VRE prevented?

Ways to prevent colonization or infection with VRE include:

  • Wash your hands often for at least 15 seconds with warm water and soap, especially before and after preparing foods, before eating, and after handling diapers and using the washroom.  This is the best way to prevent infection.  If using alcohol-based hand rub, rub your hands until dry.
  • If you work in or visit a health care facility, follow precautions asked of you by the facility.  Isolate patients who have VRE and have dedicated equipment for them.  Gloves should be worn when caring for a patient with VRE or if in contact with his/her environment.  Wash your hands properly before and after care.  Properly clean and disinfect surfaces.
  • Wash clothes when they are soiled.  They do not need to be separated from other laundry.
  • If you share a bathroom at home, clean the toilet and sink, using an all-purpose household cleaner, at least once a week.  Follow the directions on the label, and wet and rub the surfaces well.  Allow the surface to air dry.
  • If you have VRE, let your care providers know so that they can take steps to prevent the spread to others.

For more information contact the Health Unit or speak to your health care provider.

References:

  • Ontario Agency for Health Protection and Promotion, Provincial Infectious Diseases Advisory Committee. (2013). Annex A – Screening, testing and surveillance for antibiotic-resistant organisms (AROs). Annexed to: Routine Practices and Additional Precautions in All Health Care Settings. Toronto, ON: Queen’s Printer for Ontario.
  • Ontario Agency for Health Protection and Promotion, Provincial Infectious Diseases Advisory Committee. (2012). Review of literature for evidence-based best practices for VRE control. Toronto, ON: Queen’s Printer for Ontario.
  • Public Health Agency of Canada. (2016). Enterococcus faecalis. Retrieved from http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/enterococcus-eng.php.
  • Public Health Agency of Canada. (2010). Vancomycin-resistant enterococci (VRE). Retrieved from http://www.phac-aspc.gc.ca/nois-sinp/vre-erv-eng.php

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