Vancomycin-resistant enterococcus (VRE) is a bacterial infection which can be dangerous for people with compromised immune systems, such as the elderly, cancer patients, and people who have recently undergone surgery. The bulk of VRE infections are nosocomial, acquired in a hospital environment, although people can pick the bacteria up elsewhere. Treatment for vancomycin-resistant enterococcus involves culturing bacteria from the site of the infection in the lab and testing the culture with several antibiotics to find one which will be effective.
Bacteria in the genus Enterococcus are gram positive, and found naturally in the intestinal tract and female genital tract. These bacteria are infamous for their ability to exchange genetic information with other bacteria, and for their ability to develop resistance to antibiotics. The bacteria develop vancomycin resistance when they are exposed to large amounts of this antibiotic of last resort, as for example when a patient is on a long course of vancomycin to fight an infection which has not responded to other antibiotics.
People can carry vancomycin-resistant enterococcus without developing symptoms. As long as someone is reasonably healthy, the bacterial colony will not be able to compromise his or her health. However, if someone gets sick or passes the bacteria on to a person who is more vulnerable, a serious infection can result. Vancomycin-resistant enterococcus can colonize wounds, enter the bloodstream, and infect the urinary tract.
One of the biggest problems with treating VRE is that vancomycin is regarded as one of the most robust antibiotic options, reserved for use when all other antibiotics have failed. If vancomycin will not be effective, it may be a challenge to find an antibiotic which will resolve the patient's infection. Removing colonized medical devices such as catheters can help to clear the infection, and some studies have shown success with phage therapy, in which bacteriophages are introduced to kill the robust Enterococcus.
There are a number of steps which can be taken to reduce the risk of developing vancomycin-resistant enterococcus. Patients on antibiotics should make sure that they finish their courses of antibiotics fully to avoid contributing to the development of antibiotic resistance, and people should also make a habit of washing their hands before eating and after using the bathroom. In a hospital environment, hand washing between patients is a must, and people who know that they are going to have contact with someone who is immunocompromised should wash their hands beforehand to reduce the risk of passing on harmful bacteria.