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Vancomycin-resistant Enterococci (VRE)

Fact Sheet

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.