Vancomycin-Resistant Enterococcus

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VRE vancomycin-resistant Enterococcus is the bacterial strains of the genus “Enterococcus” that are resistant to the antibiotic vancomycin.  Enterococcus is part of the normal intestinal flora of humans. These microorganisms have been long recognized as important human pathogens and are even daily more on the increase. The genus Enterococcus includes about 18 species, but only […] Read More

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Vancomycin-Resistant Enterococcus

VRE vancomycin-resistant Enterococcus is the bacterial strains of the genus “Enterococcus” that are resistant to the antibiotic vancomycin.  Enterococcus is part of the normal intestinal flora of humans. These microorganisms have been long recognized as important human pathogens and are even daily more on the increase. The genus Enterococcus includes about 18 species, but only a few cause clinical infections to humans.  Everyone has enterococci. They live in your intestine and genital tract. They are also found in the environment. Most times, enterococci don’t cause problems in the body, but sometimes, however, they do. They can cause infections when they grow in colonies. When this happens, they can be treated with a powerful antibiotic called vancomycin.  Over time, enterococci develop resistance to vancomycin, and live in the antibiotic medium, even though the drug was designed to kill them. These superbugs are known as vancomycin-resistant enterococci (VRE).  CHARACTERISTICS OF VANCOMYCIN Vancomycin possesses certain characteristics that make it easily develop resistance to external attacks. They include:
  • Growth in chains.
  • Reaction with group D antiserum.
  • Growth in high salt concentration (6.5%NaCl).
  • Survival of temperature of 60, for short periods.
  • The ability to hydrolyze esculin in the presence of bile.
  • Hydrolysis of pyrrolidinyl arylamidase and leucine aminopeptidase.
RISK FACTORS OF VRE You might have a greater chance of developing a vancomycin-resistant enterococcus infection if you:
  • Have a weakened immune system.
  • Recently had surgery, especially in the abdomen or chest.
  • Have been in intensive care units, cancer, or transplant wards.
  • Have VRE already growing in colonies, in your intestine or genital tracts.
  • Were treated with vancomycin or other antibiotics for long periods.
  • Used medical devices for some time in your body (such as urinary or IV catheters).
STOPPING VANCOMYCIN RESISTANT ENTEROCOCCUS TRANSMISSION (Vancomycin-Resistant Enterococcus Reaction)
  • Vancomycin-resistant enterococci can live on hard surfaces for some time.
  • Wipe your counters, bathrooms, and other areas of your home that can provide a resting place for them, including the handles of the doors, your sets, and chairs.
  • Wash your hands with soap and water, after using the bathroom and preparing food.
  • Wash your hands after welcoming visitors.
  • Wear gloves if you’re working in close contact with body fluids like poop, treating patients’ wounds or blood. 
  • Always wash your hands after taking off your gloves.
  • Inform the healthcare workers if you or someone in your care has VRE, so they can protect themselves too.
  • Use alcohol-based hand sanitizers when you can’t easily have access to water (in public places or a vehicle).
EFFECTS OF VRE VRE can infect the urinary tracts, bloodstream, and wounds from surgery. Bloodstream infections can cause:
  • Diarrhea.
  • Body aching.
  • Fever and chills.
  • Decreased urination.
  • Nausea and vomiting.
  • Rapid pulse and breathing.
Urinary tract infections (UTIs) can cause:
  • Fatigue or tiredness.
  • The frequent severe urge to urinate.
  • Dark, bloody, and foul-smelling urine.
  • Pain in the lower back, flank, or abdomen.
  • Pain or a burning sensation when urinating.
Wound infections linked with catheters or surgery can cause:
  • Soreness and swelling at the injury site.
  • Pus or fluid leakage from the wound.
  • Red and warm skin around the wound.
COMPLICATIONS OF VRE
  • Meningitis.
  • Pneumonia.
  • Pelvic infections.
  • Wound infections.
  • Urinary tract infections.
  • Endocarditis (infection of a heart valve).
  • Intra-abdominal infections (such as peritonitis).
  • Bacteremia (a bacterial infection spread into the bloodstream).
In 2019, the Centers for Disease Control and Preventions (CDC), in their reports classified VRE in the “serious categorizing,” having declared VRE to have caused an approximate 54,500 infections among hospitalized patients and left 5,400 people dead. VANCOMYCIN RESISTANT ENTEROCOCCUS TREATMENT Vancomycin-resistant enterococci infections are treated with antibiotics other than vancomycin. Typically, fewer antibiotics can kill VRE.  Options for the treatment of serious VRE infections include penicillin or amoxicillin +/- aminoglycoside, daptomycin, tigecycline, linezolid (LZD), quinupristin-dalfopristin (QPD), telavancin, and teicoplanin (not available in the USA).  There, antimicrobials have been used with success against various strains of VRE. A combination of various antibiotics has also been found to show some level of success in treating VRE.

Symptoms

VANCOMYCIN RESISTANT ENTEROCOCCUS SYMPTOMS

Some of these may come from the infections they trigger. Symptoms of VRE may include:

  • Wound infections.
  • Bloodstream infections.
  • Urinary tract infections (UTIs).

Your doctor will take a sample from the affected, for a test. If it confirms the spread of VRE, more tests will be done to find out which antibiotic will be best to treat it.

FAQ

  • Can VRE be controlled with antibiotics?

Yes, vancomycin-resistant enterococci (VRE) can be treated with other antibiotics besides vancomycin itself. These include doxycycline, rifampin, and chloramphenicol, in various combinations. However, newer antibiotics are available. 

  • Does VRE ever go away?

Vancomycin-resistant enterococci (VRE) infections disappear in some people, as these people’s bodies get more immunized; taking a few months or longer. VRE infections can also go away and come back, but the bacteria will remain without causing infections.

  • How is VRE transmitted?

Vancomycin-resistant enterococci (VRE) are transmitted via directly contacting hands, surfaces, or equipment contaminated by body fluid of a VRE-infected person. They are not transmitted by coughing, sneezing, or via air.

  • How is VRE diagnosed?

When your doctor suspects you’ve gotten infected with vancomycin-resistant enterococci (VRE), he/she will take a sample of your infected wound, blood, urine, or excreta to a lab, for analysis. The laboratory will grow the bacteria (via culture) and test to see which kinds of antibiotics can kill the bacteria. This may take several days.

  • What are the symptoms of VRE?

When vancomycin-resistant enterococci (VRE) are causing a wound infection, the area of your skin affected by it may be red or tender, but if you have a urinary tract infection, you may have back pains, a burning sensation during urination, or a need to urinate more often than normal. Some people with VRE infections have diarrhea, feel weak and sick, or have fever and chills.