Vancomycin-Resistant Enterococci (VRE)

Routine tests were carried out whilst you were in hospital. The tests have found that you are either:

• a carrier of Vancomycin-Resistant Enterococci (VRE) called colonisation; or

• that you have an infection with VRE.

This leaflet explains what the infection is and how it is treated. We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of ward staff or the Infection Prevention and Control Team.

What is VRE?

Enterococci are bacteria that are found in the bowels of most humans.

Vancomycin-Resistant Enterococci (VRE) are enterococci that are resistant to glycopeptide antibiotics. Glycopeptide antibiotics include Vancomycin and Teicoplanin.

VRE are sometimes also called GRE (Glycopeptide-Resistant Enterococci).

How is VRE spread?

• VRE can be passed from person to person via hands or objects contaminated with the enterococci bacteria. The person with the contaminated hands then touches their mouth, wounds, or other entry sites into their body and becomes infected.

• The second way VRE can be spread involves the spread of GRE bacteria to areas of the body where they are not normally found. GRE bacteria lives harmlessly in a person’s gut.

How is the infection diagnosed?

The infection is usually first found when a patient is admitted to hospital. A urine or blood sample is taken, or a rectal or wound swab is done and sent to the laboratory for testing. The test results show the infection.

Do these bacteria always cause infection?

No. People often carry the bacteria without any symptoms or harm (called colonisation), but it can sometimes lead to infection.

What infections can VRE cause?

VRE can cause:

• Wound infections.

• Bacteraemia (infection in the blood stream).

• Infections of the abdomen and pelvis.

• Infections in the bile duct, heart valves, or the urinary tract.

The resistant bacteria do not cause more dangerous infections than the sensitive strains. However, the infections may be more difficult to treat.

Can it be treated?

People who are simply colonised with the bacteria, do not need treatment. In most people these bacteria will disappear on their own over time. However, despite being resistant to many of the commonly-used antibiotics, treatment options are still available if you do get an infection.

Will I have to stay in hospital while I am being treated?

You may not have to stay in hospital until the infection is gone. You may be able to go home if you feel well enough, whether you are still carrying the bacteria or not.

How can the spread of these bacteria be prevented in hospital?

People in hospital are more at risk of infection. Their body defences are weakened by:

• illness

• surgery

• medication; and

• the use of invasive devices, such as urinary catheters and intravenous (IV) lines.

It is preferable for patients with VRE to move to a single room. Hospital staff involved in the direct personal care of these patients will wear gloves and aprons, if there is a risk that they will come into contact with the patient's:

• blood; or

• other body fluids, such as urine, non-intact skin, or mucous membranes.

The patient’s room will be cleaned daily. Any equipment used on other patients, as well as the infected patient, will be cleaned after each use.

Stopping the spread of bacteria mainly relies on everyone having good hand hygiene practices. Particularly after using the toilet or caring for wounds or devices, such as urinary catheters.

Visitors or relatives must clean their hands before and after visiting. This is good practice when visiting any patient in hospital.

Visitors must not sit on the beds or visit if they are unwell themselves.

What happens when I go home?

Having these bacteria should not affect you or your family at home. Usual personal hygiene (such as washing your hands) and household cleaning is enough. You can take part in your usual activities and people can visit your home.

Please contact your GP and tell them that you had VRE, if you have a wound and it becomes red, swollen, or oozes, or you develop a fever.

What if I have further questions?

If you have any questions or concerns, please speak to either the nurse in charge of the ward or the matron. If they are unable to help you or you need further information, please contact the Infection Prevention and Control Team on:

• Kent and Canterbury Hospital, Canterbury
  Telephone: 01227 864049

• Queen Elizabeth the Queen Mother Hospital, Margate
  Telephone: 01843 225544 extension 725-3625

• William Harvey Hospital, Ashford
  Telephone: 01233 633331 extension 723-8202 or 723-8198