Vancomycin Resistant Enterococcus (VRE)

What is Vancomycin Resistant Enterococcus?

VRE stands for Vancomycin Resistant Enterococci. Enterococci are bacteria that normally live in the gut and on the skin. Most people with VRE are colonised, which means you have it in your body, but with no symptoms – so antibiotic treatment is not required.

What Infections can VRE cause? 

VRE can cause infections such as urinary tract, wound and infections of the blood. VRE has become resistant to vancomycin and some other antibiotics, which can make infections caused by VRE more difficult to treat. There are other antibiotics that can be used to treat infections caused by VRE.

How do I get VRE?

It is often hard to know exactly where or how someone picked up a bacteria. People receiving lots of different antibiotics are more likely to develop resistant strains of bacteria such as VRE.

VRE can be spread through person-to-person contact, through sharing items with a person that has the bacteria or through contact with a contaminated surface or equipment.

Who is at risk of infections caused by VRE?

There is an increased risk for patients who:

• Have been in hospital for a long time.
• Have weakened immune systems or are in intensive care units.
• Have open wounds or surgical incisions.
• Have medical devices put in, such as catheters or cannulas.
• Have been treated with antibiotics such as vancomycin before (which can allow resistant bacteria to grow).

What happens if I am colonised with VRE or have an infection?

When in hospital you may be cared for in a single room with ensuite toilet. Hospital staff will wear aprons and gloves to care for you and perform appropriate hand hygiene. 

It might not always be possible to be cared for in a room on your own and depending on a risk assessment you may be nursed in a bay, with similar precautions. 

These bacteria may stay in the body for months, but antibiotics are not required unless you get an infection. 

How can I prevent the spread of VRE?

Both colonised and infected people can spread the bacteria. It spreads more easily in patients with diarrhoea. VRE can enter the body through open wounds and devices.  

Hand washing is important to stop the spread of VRE: 

• Regularly wash your hands with soap and water, especially after going to the toilet and before eating (staff will assist you if you need help). 
• Use alcohol hand sanitiser available on the ward when your hands are visibly clean. Soap and water hand wipes can also be used.  
• Avoid touching medical devices if you have them, such as urinary catheters, intravenous cannulas, and wounds.  
• Let staff know if you develop diarrhoea.  
• Your room or bed area will be cleaned once per day – please help the domestics by keeping your room tidy and placing your belongings in the bedside cabinet provided.  

All hospital staff should perform hand hygiene when they enter and leave your room or approach your bedside.

Will I have to stay in hospital longer?

Unless you develop an infection, you won’t necessarily need to stay in hospital longer. However, if you do develop an infection, some of the antibiotics used to treat VRE are given via injection, so you might need to stay in hospital whilst the infection is being treated.

How is VRE treated?

• Not all patients with VRE need treatment. Sometimes the bacteria live in the gut, on the skin or in wounds without causing infection.
• Despite being resistant to some antibiotics, other antibiotic options are available should treatment be required for an infection.
• Your doctor or GP will only prescribe antibiotics for an infection, as careful use of antibiotics is essential in reducing the risk of bacteria developing resistance.
• If antibiotics are needed whilst you are an inpatient, these will be prescribed using the hospitals antibiotic guidelines and monitored closely.

Is there any risk to family/visitors?

VRE is not usually a problem for healthy people. Visitors should wash their hands or use alcohol-based hand rub (hand gel) before entering the patient’s room and again when leaving. If visitors are helping with your personal care, the nursing staff may advise extra precautions, such as gloves and aprons.

What advice should I follow at home?

Good hand hygiene is important after you leave hospital. There is no need to take special precautions. Normal household cleaning practices, including your laundry should be in place.  

Please tell healthcare workers that you are colonised with VRE if: 

• You are seeing new doctors. 
• Attending a different hospital. 
• You return to hospital.
• You should tell your GP.

This is important to ensure you get effective antibiotics if you were subsequently treated for an infection. 

If you are discharged on antibiotics to treat an infection it is important that you complete the course prescribed. 

The VRE result will be on the discharge summary from UCLH, to inform your GP.

Where can I get more information?

• Talk to the medical or nursing team caring for you
• You can ask to talk to the Infection Prevention and Control Team
• UK Health Security Agency (UK-HSA)
• Enterococcus species and glycopeptide-resistant enterococci (GRE) - GOV.UK

Contact details

Infection Prevention and Control Team
Direct line: 0203 447 9716

Website: www.uclh.nhs.uk