VRE is like all enterococci—these organisms are not nearly as virulent as many of the other antimicrobial-resistant organisms (AROs), such as methicillin-resistant Staphylococcus aureus (MRSA). VRE is quite content to colonize someone rather than actually cause an infection. As a result, there is some difference of opinion in Canada on how aggressive we should be in trying to control this organism. Some hospitals treat it like other AROs while others have stopped control measures to focus on other organisms.
Infections caused by VRE can be hard to treat. Enterococci are naturally resistant to most antibiotics, and VRE is especially so. VRE tends to focus on places like the gastrointestinal tract, urinary tract, heart valves, blood, and any prosthetic devices, such as artificial joints, prosthetic heart valves, and intravenous catheters. VRE urinary tract infections are particularly common and often associated with indwelling urinary catheters.
For complex continuing care patients or long-term care clients for whom catheters are frequently used, being colonized with VRE can carry an increased risk of infection. Depending upon the site, VRE infections require prolonged (occasionally months-long) treatment with antibiotics, and the treatments may fail.
For information on screening and treating VRE, please refer to the tools and resources noted below.