Vancomycin-resistant enterococci (VRE)

Please note: This is for information only.

Refer to local guidelines for treatment recommendations


 

  • Enterococci are low-grade but opportunistic bacteria. They are found as normal inhabitants of the gastrointestinal tract.

Infections include:

  • UTI
  • Intra-abdominal sepsis (often with other bacteria)
  • Line-associated infections
  • Endocarditis

In general these bacteria are relatively resistant to many antibiotics. Amoxicillin and vancomycin/teicoplanin are the main antibiotics used to treat serious enterococcal infections.

Vancomycin-resistant enterococci (VRE) are a particular problem because they are often resistant to amoxicillin and teicoplanin as well. Infections are thus very difficult to treat, although a new antibiotic, Linezolid, is now available.

VRE don't usually cause many problems except in certain settings including:  

  • haematology
  • renal units and CAPD
  • DCC

As well as causing occasional opportunistic infections, VRE is frequently carried in the gut of patients without doing any harm. There is no way to clear gut carriage of VRE and this makes the control of VRE very difficult once it becomes established within a unit/ward.

In general a combination of Enteric Precautions and Wound and skin precautions are recommended for patients with VRE who have diarrhoea, discharging lesions or other wounds, or for a sporadic case of VRE in a Unit/Ward without an endemic problem. The Infection Control Team will advise further (see Infection Control Intranet Site)