Protocol for the Management of
Patients with Vancomycin Resistant
Enterococcus (VRE)
Overview
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What is VRE?
How is VRE spread?
VRE Patient Management
Environmental cleaning
What is VRE?
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Enterococci are Gram-positive bacteria
Normally found in the human intestines
Generally do not cause harm
Vancomycin is an antibiotic
Enterococci may become resistant to
Vancomycin
How is VRE spread?
• VRE is spread from person to person by:
– From patient to patient via unwashed healthcare
worker’s hands
– From a contaminated environment via unwashed
healthcare worker’s hands
– Through equipment that hasn’t been cleaned
appropriately
Patient Isolation
• Contact precautions
• Patients must be cared for in:
– Single room with unshared ensuite
– A shared room with other patients who have VRE
• In ambulatory settings:
– Do not segregate in waiting rooms
– Place patients into an examination room without
delay
Personal Protective Equipment (PPE)
• PPE must be worn:
– Prior to entering the patient environment
– Removed before exiting the patient environment
• Aprons (staff must ensure their arms are “bare
below the elbows”)
• Or a gown
• Gloves
Environmental Cleaning
• One-step process:
– Combined detergent and 1000 ppm available chlorine
solution
• Cleaning shall occur:
– Daily or routine
– On transfer or discharge of the patient
– Discharge cleaning of renal dialysis and day therapy
unit areas of VRE carriers
– For shared patient care devices for patients with VRE
Environmental Cleaning
• Maintain transmission-based contact
precautions
• Daily clean of:
– All patient surrounds
– Commonly touched objects
– Refer to QH – Cleaning Services, Policies,
Standards and Operational Guidelines 2012
More information?
• Queensland Health Protocol: Management of
Patients with Vancomycin Resistant
Enterococcus (VRE) available from:
http://www.health.qld.gov.au/directives/docs
/ptl/qh-hsdptl-029-2.pdf