Vancomycin-resistant Enterococci (VRE)

Fact Sheet
 What is Vancomycin-resistant Enterococci?
 How are VRE infections spread?
 Who gets VRE infections?
 How is a VRE infection diagnosed?
 How are VRE infections treated?
 How can I prevent the spread of VRE?
 What is the Government of Canada doing to address VRE
infections?

What is Vancomycin-resistant Enterococci?

Enterococci are bacteria that live in the human intestine, in the urinary
tract and are often found in the environment. Generally these bacteria
do not cause illness; however when illness does occur it can usually
be treated with antibiotics. Vancomycin-resistant Enterococci (VRE)
are strains of enterococci bacteria that are resistant to the antibiotic
vancomycin.
Vancomycin is an antibiotic generally prescribed to treat serious
infections caused by organisms that are resistant to other antibiotics
such as penicillins.
With VRE, it means vancomycin is not effective in treating an infection
with enterococci bacteria.
You can have VRE present in your body without being sick. A person
with VRE who does NOT have symptoms is colonized with VRE. A
person is considered to be infected with VRE when
symptoms ARE present (e.g. an infection of the urinary tract or
bloodstream).
How are VRE infections spread?
Often, VRE spreads within healthcare facilities. It can spread from
patient to patient when bacteria is carried on the hands of healthcare
workers and occasionally through contact with contaminated
equipment or other surfaces (e.g. toilet seats, bedrails, door handles,
soiled linens, stethoscopes etc). This is why proper infection
prevention and control practices, such as proper hand hygiene and
the use of personal protective equipment such as gloves are important
in hospital settings.

Who gets VRE infections?

VRE infections occur most commonly in healthcare settings among
patients with weakened immune systems. Those who have been
previously treated with vancomycin or other antibiotics for long periods
of time; those who have undergone surgical procedures and those
with medical devices such as urinary catheters are at a higher risk of
becoming infected with VRE.

How is a VRE infection diagnosed?

To diagnose a VRE infection, a sample from the infected area is
taken. The type of sampling depends on the type of infection, however
often urine or wound samples are taken. The organism sample is then
grown in the laboratory. If the organism tests positive for VRE, it is
tested further to determine which antibiotics may be effective for
treating the infection.

How are VRE infections treated?

People who are colonized (bacteria are present, but they have no
symptoms of an infection) with VRE do not usually need treatment.
Most VRE infections can be treated successfully with antibiotics other
than vancomycin. Laboratory testing of the VRE sample can
determine which antibiotics will successfully treat the infection.
How can I prevent the spread of VRE?
Proper hand hygiene is one of the most effective ways to reduce the
risk of acquiring an infection, including VRE. Wash your hands
thoroughly after using the bathroom, before preparing food or after
contact with a person who has VRE. Wash with soap and water or use
alcohol-based hand rubs. It is important to remember that VRE can
survive for weeks on surfaces and objects so you should regularly
clean areas such as bathrooms and frequently touched surfaces (e.g.
door handles).

What is the Government of Canada doing to address VRE

infections?
The Government of Canada is committed to working with its partners
at all levels of government, hospitals and within the communities to
reduce the incidence and spread of antibiotic resistant infections.
The delivery of health care is a provincial/territorial responsibility. The
role of the Public Health Agency of Canada (PHAC) is to develop
guidelines and conduct ongoing surveillance that allow provinces and
territories to make informed decisions and implement effective policies
to address this issue.
PHAC’s Canadian Nosocomial Infection Surveillance Program is an
important part of a multi-pronged approach to addressing healthcare-
associated infections. It provides evidence-based surveillance data
that can be used to establish benchmarks and identify trends in
healthcare-associated infections. This data help inform the Agency’s
guidance on infection prevention and control practices. PHAC’s
guidance documents are developed for use by provinces and
territories, health care facilities and health care personnel across
Canada, which aim to limit the spread of hospital acquired infections,
including VRE.