VRE bacteria: complaints, symptoms, infection and treatment

VRE is an abbreviation of ‘Vancomycin Resistant Enterococcus’. Enterococci are bacteria that occur in the intestines of healthy people. They are harmless there, but sometimes enterococci can cause infections, especially in patients with reduced resistance. An infection can then develop in the bloodstream, urinary tract, brain or heart valves. VRE can also cause infections in open wounds. VRE infections usually occur in people who are already ill and in the hospital. The VRE bacterium is difficult to treat because it is insensitive to common antibiotics, including vancomycin. Some VRE infections can be life-threatening.

  • What is a VRE bacterium?
  • Vancomycin Resistant Enterococcus
  • Healthy and seriously ill people
  • Hospital bacteria
  • Symptoms
  • Causes
  • What risks are associated with an outbreak with the VRE bacteria?
  • Examination and diagnosis
  • Therapy
  • Prognosis
  • Prevention

What is a VRE bacterium?

Vancomycin Resistant Enterococcus

VRE is an abbreviation that stands for ‘Vancomycin Resistant Enterococcus’. This is a so-called multi-resistant enterococcus. Multi-resistant means that this bacterium is insensitive (= resistant) to common antibiotics. Enterococci are bacteria that occur in the gastrointestinal tract (digestive system) of humans (and animals), without you noticing anything. They are not very virulent, which means that they have a low pathogenic potential. This is in contrast to other microorganisms.

Healthy and seriously ill people

The bacteria are not very pathogenic (for healthy people). However, this bacterium can sometimes cause inflammation in seriously ill people. The risk of infections is increased, especially in a hospital environment. This is because in such an environment a selection of resistant bacteria arises as a result of the use of antibiotics. In addition, a patient’s immune system is disrupted by serious underlying suffering or as a result of the treatment; for example, there may be a surgical wound.

MRSA bacteria / Source: NIAID NIH, Wikimedia Commons (Public domain)

Hospital bacteria

The VRE bacterium is also called a ‘hospital bacterium’. This is in fact a collective name for bacteria that can cause infections in hospital patients. A more well-known hospital bacterium is MRSA.

Symptoms

Normally healthy people who are carriers of the VRE bacteria have no complaints. However, this bacterium can cause infections in seriously ill and bedridden patients in hospital. However, it rarely happens that the bacteria cause serious infections. The problem lies in the resistance of the bacteria. The VRE bacterium is insensitive to many types of antibiotics, which means that common antibiotics do not work well and this problem can only be treated with special antibiotics.

Causes

The VRE bacterium is an intestinal bacterium that can be transmitted through contact with feces or contaminated objects, such as a door handle, a keyboard, telephone, remote control or toilet seat. The bacterium does not move through the air. Transmission of the bacteria can be prevented by adhering to adequate hygiene measures. It is advisable that you wash your hands thoroughly after every visit to the toilet.

What risks are associated with an outbreak with the VRE bacteria?

According to the National Institute for Public Health and the Environment (RIVM), two problems can be identified:

  1. Seriously ill hospital patients who contract this bacteria can become even sicker. In practice, according to the RIVM, this only rarely happens.
  2. There is also a small chance that the VRE bacteria will transfer its insensitivity to the antibiotic vancomycin (the standard antibiotic) to other bacteria. There are several hospital bacteria that can only be treated with vancomycin, such as the aforementioned MRSA bacteria. If this culprit also becomes insensitive to vancomycin and infects a seriously ill patient, one must switch to agents that have more side effects or with less clinical experience, according to the RIVM.

Examination and diagnosis

The doctor takes a sample of blood, urine, pus, or other fluid from the infected area. The sample is sent to a laboratory to be examined for VRE.

Therapy

Active VRE infections are treated with an antibiotic that is not vancomycin. The treating doctor can take a culture of the bacteria and have it tested in a laboratory to see which antibiotic works best. In 2023, researchers are working on the development of new types of antibiotics that can be used to treat VRE.

Prognosis

Your prognosis depends on the type of infection you have and your overall health. It can be challenging to treat VRE because it is resistant to vancomycin. However, other antibiotics can treat the infection.

Prevention

Healthcare workers can prevent VRE contamination by keeping all surfaces and medical equipment clean. They must wash their hands with soap and water before working with a patient. They should also wear disposable gloves. Hospitals may take special precautions to prevent the infection from spreading to other patients.

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