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Vancomycin-resistant Enterococcus

Definition

Enterococcus is a common bacterium that is normally found in the lower intestine. Sometimes this bacterium causes infections and requires treatment. Only a few antibiotics can effectively treat enterococci infections, and one of them is Vancomycin. Vancomycin-resistant Enterococcus (VRE) is resistant to vancomycin and therefore this antibiotic will not be able to destroy the bacteria.

Hospitalized patients with weakened immune systems, those who have taken many antibiotics, or people who have many medical conditions are at higher risk for VRE.

VRE is most often found in the stool, but can also be found in urine, blood, infected wounds, other body fluids, or other sites. Some people carry enterococcus, or become colonized, but do not have an infection. However, sometimes enterococcus causes infections, which means the bacterium is making them sick.

Transmission

VRE can be spread or transmitted to other people through touch. It is mainly spread by contact with unwashed hands or gloves. VRE can live on regular surfaces for five to seven days (5 to 7 days) and on hands for several hours. VRE can also be spread on the hands of health care providers and medical equipment, if not properly disinfected. VRE has also been found in the community. 
 
Precautions

Special precautions are needed in order to prevent the spread of the germ to other patients in the hospital who are also ill and therefore most likely to develop an infection. If a patient develops VRE, Infection Control personnel will decide whether they need to stay in their room. If they are asked to stay in their room, Infection Control staff will advise their health care provider when and how often they may leave their room. In some cases, visitors may be limited to a few at a time.

Patients will be taught how to wash their hands with a skin antiseptic. They must wash their hands after using the toilet and every time before leaving their room.

Signs will be placed outside the room to remind everyone about the special precautions. Do not be shy about reminding everyone to wash. Infection Control personnel will decide if people taking care of the patient need to wear gowns and/or gloves. The room may be specially cleaned to remove the VRE germs.

Leaving the hospital: If the patient goes to another health care facility or has services in their home, some precautions might be needed. This is to prevent caregivers from picking up the germ and spreading it to other patients. Good hand washing is very important to reduce the risk of spread.

At home: VRE is no more dangerous than other normal bacteria that people carry on their skin and are exposed to every day. Carry on with usual activities and remind everyone to wash their hands often. You should wash your hands after you go to the bathroom or touch your wound as a matter of routine, not just for VRE.

Performance

North York General Hospital regularly monitors and reviews infection rates and uses this information to execute best practice protective measures and continually improve patient care and safety.
 
Access the rate of hospital-acquired VRE (calculated as the total number of patients with hospital-acquired VRE per 1,000 inpatient days) bloodstream infections and the absolute number of cases in the monthly reporting period.
 
Learn more about public reporting and patient safety on the Health Quality Ontario website.

What we are doing to improve patient safety

Our hospital has undertaken many initiatives to provide patients with safer care. One of these, North York General Hopsital's Infection Prevention and Control (IPAC) initiative, is improving patient safety in a number of ways, including:
  • Developing a comprehensive system for screening and surveillance of high-risk patients for infectious syndromes (e.g. diarrhea, meningitis, etc.) and antibiotic-resistant organisms (Methicillin-resistant Staphylococcus aureus or MRSA, Vancomycin-resistant Enterococci or VRE, C. difficile, etc.)

  • Enhancing our Infection Prevention and Control Program

  • Actively implementing an aggressive hand washing campaign across the entire hospital to dramatically increase hand washing compliance rates

  • Engaging North York General staff in developing plans to respond to pandemic influenza

  • Actively participating in community education by hosting our region's Infection Prevention and Control Network.