What are Vancomycin–Resistant Enterococci?

Enterococci are bacteria (germs) that live harmlessly in the bowels of humans without causing ill effects, this is called colonisation. Enterococci can be resistant to vancomycin, an antibiotic used to treat infections. When these bacteria are resistant to vancomycin they are referred to as Vancomycin-Resistant Enterococci or VRE.

How will I know if I am at risk?

VRE is commonly found in people who have been taking antibiotics for a long-time including vancomycin or have a weakened immune system, such as patients in intensive care units, people who have an illness that harms the body’s ability to fight infection or people receiving renal dialysis. Those who have long stays in hospital or have medical devices such as a urinary catheter in place for a long time or have undergone procedures such as abdominal or chest surgery are also more at risk of becoming colonised or infected with VRE. 

What symptoms might I have?

If you have tested positive for VRE this means that you have the bacteria within your body. You may not show any symptoms (colonisation); the bacteria are living harmlessly in your bowels without causing illness.

If they get into other parts of the body e.g., a wound, urine, or blood, they can cause an infection requiring treatment and then you may feel unwell. 

Whilst VRE does not cause diarrhoea, it could spread more easily if you are suffering from diarrhoea. 

How is VRE spread?

VRE is spread directly or indirectly by faecal contamination of the hands or objects (e.g., through poor hand hygiene after going to the toilet), and then introduced into the mouth.  It can also be spread on the hands of patients, relatives, and healthcare workers after contact with an infected patient or contaminated equipment.

What happens if I test positive for VRE?

While you are in hospital you will be cared for in a single room with your own toilet facilities. Staff caring for you will wear personal protective equipment such as disposable gloves and aprons to prevent spreading the bacteria to other patients.  

The most effective method of preventing spread of infection is hand hygiene. It is very important to wash your hands with soap and water after using the toilet and before eating, staff will help you if needed.

It is also important that healthcare staff and visitors wash their hands with soap and water or use alcohol gel (if hands are visibly clean) before entering and leaving your room.

If you have any wounds or medical devices such as intravenous drips or a urinary catheter, then you should avoid touching these.

Can I have visitors?

The risk to visitors and relatives is low if they are fit and well. If they are feeling unwell, please ask them not to visit until they are feeling better. Ask a member of staff for advice if you are unsure. Children and babies are more prone to infections so are advised not to visit.

Visitors should follow the instructions on your door or from staff before entering your room. 

Prevention of infection rests mainly on good hand hygiene for you and your visitors. We ask that they wash their hands before leaving your room and they do not to mix with other patients. Visitors do not need to wear apron and gloves during their visit unless they are helping you with your care e.g. personal hygiene. If they are visiting someone else apart from you, it is best if they see them first. 

What happens when I leave hospital?

You will not have to stay in hospital any longer than necessary, you will be allowed to go home when your condition allows. This should not be a risk to your family or friends. Staff from the hospital will inform your GP of your positive VRE result. Remember hand washing is very important to prevent these bacteria spreading. Wash your hands after using the toilet and before eating.  Anyone who is caring for you should regularly wash their hands to prevent spread of VRE.

If you have any medical devices such as urinary catheters, you should only touch these if instructed to clean them. 

You can continue leisure and social activities as normal.

Make sure that toilets and bathrooms are cleaned regularly, washing of crockery and cutlery can be completed as normal. Laundry can also be completed as normal. Ensure that you and/or person helping with laundry wash their hands with soap and water after handling dirty/soiled linen.

What if I need to go back into hospital or attend an outpatient appointment?

If you are admitted back to hospital or attend an outpatient appointment you should inform the staff caring for you that you have had a positive test for VRE in the past. This will make sure that you receive the best care to reduce the risk of you developing a VRE infection.

If you encounter any other healthcare professionals such as district nurses, please inform them too.

Where can I get more information?

If you have further questions, please discuss them with a member of the ward team.  You can also ask to speak with a member of the Infection Prevention and Control Team.

The UK Health Security Agency (UKHSA) formerly Public Health England website is another source of information. UK Health Security Agency - GOV.UK (www.gov.uk)