VRE Information Sheet for Patients and Families
You or a family member has been placed in isolation precautions due to a laboratory
sample showing the presence of the bacteria Vancomycin-resistant Enterococci,
commonly referred to by its initials VRE. VRE is a bacterium that is resistant to some
antibiotics. We can treat it successfully with a variety of antibiotics; however we don’t
want it to spread to other patients. That’s the reason for the isolation precautions. The
following are some commonly asked questions about VRE. Your doctor and nurse can
answer other questions if they are not answered here. For any other questions contact the
Infection Control Department at 42188.
What’s an Enterococcus?
This is a bacterium (germ) that lives in everyone’s colon (large intestine). Virtually every
human, and many animals, carry Enteococci in their intestines. In healthy people,
Enterococci almost never cause disease. They become a problem only in very sick
individuals who are in the hospital. In these people, it occasionally causes serious
problems such as bloodstream infections, bladder infections and wound infections.
What is Vancomycin-resistant?
Vancomycin is a commonly used antibiotic that is frequently used to treat infections due
to Enterococci. In recent years some Enterococci have figured out how to resist the
effects of vancomycin where it may no longer be effective for treating some infections.
Additionally VRE has also figured out how to resist many other commonly used
antibiotics. There are still antibiotics that will work to treat VRE but they are often more
expensive and sometimes harder to use. Fortunately, as mentioned above, VRE has
limited ability to cause disease. Unfortunately we have found that it is able to sometimes
transfer its ability to resist the effects of vancomycin to other more potent germs.
What is infection vs. colonization?
In most cases VRE simply lives in the colon and never causes any problems. This is
referred to as colonization. This is why some patients may be placed in isolation
precautions but show no signs of infection and not be on antibiotics. Sometimes, when
patients are very ill, have been in the hospital a long time, and have received a lot of
antibiotics, VRE may travel to parts of the body and cause infections. This may show up
as fevers, a high white blood cell count a bladder infection, blood poisoning etc.
How did I get VRE?
At the time of this writing VRE was still pretty rare at UMC and in Mississippi. Most
VRE is transmitted on the hands of caregivers who haven’t adequately washed their
hands after having contact with a colonized individual. This may happen in the home, the
nursing home, or the hospital. It is frequently impossible to know where it came from
since it may live in the colon for months prior to it being recognized.
How do you know that I have VRE?
Your doctor has ordered a test sample from your wound, urine, blood, or stool. The test is
called a culture. Your culture has tested positive for VRE.
What will this mean for my hospital care?
All patients with a positive culture for VRE are placed in isolation. Isolation is used to
keep from spreading VRE to other patients. There will be a cart outside the room to hold
supplies. A card will be placed on the door to alert everyone to what precautions are
needed to enter your room. Hospital staff will wear gowns and gloves to care for you.
Visitors should report to the nurse’s station for directions on what to do to enter your
room. All of these precautions are intended to keep VRE from spreading to others.
Patients in isolation for VRE may leave their room for tests, but must first wash their
hands and put on a clean cover-gown. Patients on VRE isolation may also walk in the
halls. They should also wash their hands before leaving the room and put on a clean
cover-gown. If you walk in the hall you should avoid touching other patients. Also, you
should avoid common areas like nurse’s stations, waiting rooms, play rooms, the
cafeteria etc. Hospital staff will need to clean any equipment, such as IV poles, with a
disinfectant.
What happens when I go home?
As mentioned above, VRE is not very able to make healthy people sick. Once you are at
home and no longer taking antibiotics the number of VRE will decline, and it is generally
just a harmless inhabitant of the colon. All you really need to do is assure you wash your
hands frequently, especially following using the toilet.
What will happen if I’m back in the hospital or come back to clinic?
We want to prevent the spread of VRE to others. If you come back into the hospital you
will again be placed in isolation precautions. Cultures may be taken again to see if you
still carry VRE. When you come back for a clinic appointment, please tell the doctors
and nurses you have VRE so that they can take steps to avoid spreading it to others.
Will I ever get rid of VRE?
Over time VRE disappears from the colon of many individuals. Once a patient no longer
receives antibiotics it is crowded out by the normal bacteria in the colon. Once cultures
for VRE become negative, you will no longer need to be in isolation.