Avoiding Hospital-Acquired Vancomycin-Resistant Enterococci

While hospitals can provide life-saving treatment, they can also become the source of potentially serious infections that are resistant to standard treatments. Vancomycin-resistant enterococci, or VRE, is an infection that began appearing in hospitals in the early 1990s. While not as terrifying as flesh-eating bacteria, VRE can cause significant problems.

Daughter talking to her father in a hospital bed
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What Are Enterococci?

Enterococcus (the plural form is Enterococci) is a type of bacteria found naturally in the body's intestinal tract and in the genital tracts of women. As long as they stay in the intestinal or female genital tract, they don't usually cause problems and do not need to be treated. This is known as a "colonization" rather than an "infection." However, enterococci can cause dangerous infections in other parts of the body like the urinary tract, the bloodstream, a wound or a catheter insertion site if it travels to them.

Antibiotic Resistance and Superbug Survival

Antibiotics are drugs that can kill or inhibit disease-causing bacteria. Unfortunately, antibiotics are commonly overused and misused. As a result, bacteria that should be destroyed by antibiotics have, in some cases, become antibiotic-resistant.

Vancomycin is an antibiotic that has been around for more than 50 years. It was originally developed for infections that are resistant to penicillin, including MRSA (methicillin-resistant Staphylococcus aureus) and the oral form is used to treat another tough infection, C. difficile.

But, in recent years, some of those more aggressive infection-causing bacteria, like MRSA, have become resistant to vancomycin, too. Those bacteria that used to succumb to vancomycin have evolved to be able to tolerate it. Included is one form of enterococcal infection, now widely known as VRE. While it is not always lethal, it can cause serious illness or death, particularly in older, sicker people with weakened immune systems.

Who Is at Risk?

Medically ill patients are at increased risk of developing and dying from a VRE infection. This includes:

  • People who are elderly and frail
  • Those previously treated for long periods of time with vancomycin or other antibiotics
  • Hospitalized patients, particularly those receiving long courses of antibiotics
  • Immunocompromised patients in such as those in intensive care units, cancer or transplant units
  • Surgical patients who have undergone procedures involving the abdomen or chest.
  • People with medical devices such as urinary catheters or central intravenous (IV) catheters
  • People who are colonized with VRE

Preventing VRE and Other Hospital-Acquired Infections

Prevention of VRE, like all other hospital-acquired infections, is key. Whether you are a patient, a caregiver or a patient advocate, follow the steps to prevent a hospital-acquired infection. These include:

  • Careful and frequent hand-washing
  • Immediate and appropriate treatment of cuts, scrapes, or other breaks in the skin
  • Careful cleaning of personal care items such as razors and toothbrushes
  • Minimizing the length of use of catheters, and careful and appropriate use of such devices when needed
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By Trisha Torrey
 Trisha Torrey is a patient empowerment and advocacy consultant. She has written several books about patient advocacy and how to best navigate the healthcare system.