JHH HEIC - VRE (Patient Education)



Specific Disease Information
MRSA
RSV
VRE
On Isoaltion
In The Hospital

Patient & Visitor Information

Vancomycin Resistant Enterococci (VRE)

Patient Education Reference 160 (PDF Format)

VRE: Description and Epidemiology

VRE: The Facts

For More Information

John Hopkins Standard Teaching Plan for VRE

What does antibiotic resistance mean?
Germs called bacteria may cause infections. Antibiotics are drugs used to treat infections caused by bacteria. Sometimes these drugs will no longer kill the germs. This is called antibiotic drug resistance.

What are enterococci?
Enterococci are germs that are normally in the bowel. Enterococci can go to other parts of the body and cause an infection. Vancomycin is a drug (antibiotic) used to treat infections caused by enterococci. If a germ is resistant to vancomycin, treatment with vancomycin will not get rid of the infection. These germs are called "Vancomycin Resistant Enterococci" or VRE for short.

What is infection vs. colonization?
An infection means that germs are in or on the body and make you sick which results in signs and symptoms such as fever, pus from a wound or a high white blood cell count. Germs can also be in the body, but not make you sick. This is called colonization. People who are colonized will have no signs and symptoms. They will feel fine. VRE can cause infection and colonization.

What are risk factors for getting VRE?
Patients at most risk for getting VRE are those who have been in an intensive care unit, sick with a long term illness, have been on many different types of antibiotics, have had major surgery or an organ or bone marrow transplant.

How do I know if I have VRE?
If your doctor wants to test you for VRE, a sample of your blood, urine or stool is sent to the lab to see if VRE is present. This test is called a culture. If there is VRE in the sample, the culture is positive. This means that you have VRE in your body.

What will this mean for my hospital care?
All patients who have a positive culture for VRE are placed in isolation. Isolation is used to keep from spreading VRE to other patients. There will be a cart outside the room to hold supplies. A card will be placed on the door to alert everyone what precaustions are needed to enter the room. Hospital staff will wear gowns and gloves to care for you. Visitors should report to the nurses station for directions on what to do to enter your room. All of these steps are to keep germs from spreading.

Am I contagious?
VRE can not be spread by coughing or sneezing. VRE can be on your hands, and can get there from your stool or urine. You can then spread it to anything you touch if you do not clean your hands. Hands must be washed with soap and water for ten seconds or cleaned using a waterless hand cleaner. Handwashing after using the toilet is very important. In some cases VRE will go away for a time, but then it may come back. Cultures can be taken to see if it goes away. Unfortunately, eveb after VRE gies away, as soon as you require antibiotics again, VRE usually comes back. For this reason, HEIC does not recommend routinely re-culturing to take you out of isolation.

What will happen when I go home?
At home, in most cases, you only need to use good handwashing. Healthy family members are not likely to get VRE. Based on your discharge needs, instructions will be given by the nursing staff.

What will happen if I'm back in the hospital or come to clinic?
The Johns Hopkins Hospital wants to prevent the spread of VRE. If you come back into the hospital, you will be placed in isolation again. When you go to doctor's offices or to hospital clinic appointments, you should tell the doctors and nurses that you have VRE, so they can take steps to avoid spreading it to others.

Will I ever be rid of VRE?
Over time your normal bowel organisms may take the place of VRE. You will no longer be isolated when three stool or rectal swabs taken a week apart are negative for VRE.

Where can I get more information about VRE?

Talk to your doctor or nurse.
Call The Johns Hopkins Hospital: Hospital Epidemiology/ Infection Control Department at 410-955-8384.
Review the centers for Disease Control and Prevention (CDC) website http://www.cdc.gov.

Developed by the Johns Hopkins Hospital: Hospital Epidemiology and Infection Control Department.