Vancomycin-resistant enterococci (VRE) are Gram-positive bacteria. Vancomycin-resistant enterococci cause infections in hospitals and other settings and demonstrates intrinsic and acquired antibiotic resistance, VRE are considered a serious threat by the US CDC.
VRE caused 54,500 cases & 5,400 deaths in 2019. VRE infection can be acquired in the hospital and can cause urinary tract and blood stream infections as well as surgical site infections, and complicated intra-abdominal infections [1].
1. Types of Illnesses caused by Vancomycin-resistant Enterococcus
(a) UTIs
Risk for infection in the urinary tract includes indwelling urinary catheters.
(b) Bacteremia
Bacteremia is the presence of bacteria in the bloodstream. It’s due to many causes, including surgery and childbirth. In hospital settings, Vancomycin-resistant Enterococcus illnesses have also been linked to bacteremia in hospitalized patients [1], including those who have undergone major abdominal surgery, those with infected wounds or urinary catheters, and more.
(c) Endocarditis
Endocarditis is an infection of the inner membranes that line the heart chambers. The most common causes are bacteria, but fungal organisms and viruses can also cause the disease. VRE is linked with endocarditis in patients with infective endocarditis [2] and can be difficult to treat.
(d) Sepsis
Sepsis is a type of systemic infection caused by bacteria and other microorganisms. It can lead to death if proper treatment is not given. Septic shock occurs when the disease affects significant organs. It may also occur in patients who have undergone surgery and those with compromised immune systems.
(e) Surgical Site Infections
Intra-abdominal infections often have enterococci as a cause. The National Healthcare Safety Network have identified enterococci (including VRE) as important causes of central line-associated bloodstream infections and a significant cause surgical site infections. Surgical site infections develop because of surgical procedures and are usually caused by bacterial infections.
2. Ways to Keep VRE from Spreading
Hand hygiene and contact precautions including gowns and gloves are used when contacting patients with known VRE.
3. Treatments of VRE
Although some precautionary actions have been taken, VRE treatments and preventing VRE remain a persistent issue in many hospitals. In the interim, research indicates that proper management of antibiotics and stringent adherence to infection control protocols is the most effective means for curtailing and preventing VRE, particularly among those deemed high-risk. Crestone has developed novel antibiotics with exquisite activity against the enterococci including VRE.
Resources
- Levitus, Matthew, et al. “Vancomycin-Resistant Enterococci – Statpearls – NCBI Bookshelf.” National Library of Medicine, 18 July 2022, https://www.ncbi.nlm.nih.gov/books/NBK513233/
- “VRE in Healthcare Settings.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 13 Nov. 2019, https://www.cdc.gov/hai/organisms/vre/vre.html
- Cappelli S;Corallino D;Clementi M;Guadagni S;Pelle F;Puccica I;Barba M;Vici P;Sperduti I;Costantini M;Botti C; “Surgical Site Infections in Patients Undergoing Breast Oncological Surgery during the Lockdown: An Unexpected Lesson from the COVID-19 Pandemic.” Il Giornale Di Chirurgia, U.S. National Library of Medicine, 22 July 25AD, https://pubmed.ncbi.nlm.nih.gov/35936027/
- Fang, H, et al. “Recommendations for Preventing the Spread of Vancomycin Resistance Recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 31 Mar. 2012, https://www.cdc.gov/mmwr/preview/mmwrhtml/00039349.htm