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VRE: Vancomycin Resistant Enterococci

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What is VRE?

Enterococci are bacteria (germs) that live in the gastrointestinal tract (stomach and bowels or GI tract). Most of the time, enterococci do not make people sick. People who have the bacteria in their GI tract but are not sick are said to be colonized . But in some people, enterococci can cause serious infections in the blood, urinary tract and wounds. These infections can usually be treated with antibiotics. Vancomycin is the name of an antibiotic that is used to treat serious bacterial infections. When vancomycin cannot kill the bacteria, we say they are vancomycin-resistant. If this happens, we will need to use a different antibiotic. 

Who is at risk for VRE?

Children and teens at highest risk to get infected or colonized with VRE are those who have:

  • Had a stay in hospital.
  • A serious illness that affects the body’s ability to fight infection, like patients with cancer or an organ transplant.
  • Other serious illnesses, like patients in the intensive care unit.
  • Taken many antibiotics.
  • Devices like urinary catheters, central lines and feeding tubes.
  • Been in contact with a patient with VRE, or areas in a healthcare centre where VRE is present.

How is VRE spread?

VRE is spread from one person to another by touch. Someone with VRE on their hands can pass it to others by touching them. VRE can also live on things in the hospital, like toilet seats, door handles, bed rails and shared patient equipment.

How can we prevent VRE from spreading?

VRE is easy to kill with proper cleaning methods and by keeping hands clean. The best way to prevent VRE and lots of other infections from spreading to others is by washing your hands and your child’ s hands with soap and water (for 15 seconds) or with alcohol-based hand rub (rub until dry). Keeping your child’s hospital room free from clutter helps us to clean the room properly. 

Keep hands clean!

he best way to prevent VRE (and other infections) from spreading to others is by washing your hands and your child’s hands. Wash with soap and water for 15 seconds. You can also use alcohol-based hand rub (rub until dry). 

Clean hands of ten:

  • After using the bathroom or changing a diaper
  • After blowing your nose
  • Before preparing or eating food and drink
  • After contact with body fluids
  • After changing a bandage
  • If you can see dirt on your hands

Remember!
If you can see dirt on hands, alcohol-based hand rubs won’t work. You must wash with soap and water.

What will VRE mean for my child or teen’s hospital stay?

Your child or teen may need to be tested for VRE when admitted to CHEO. If children or teens test positive for VRE, they will be isolated (placed on Contact Precautions).

This means:

  • They will not share a room with other patients.
  • They cannot leave their room unless they are taken by hospital staff for tests or appointments.
  • Hospital staff and doctors will wear gowns and gloves when taking care of them.
  • Everyone who leaves the room must be careful to clean their hands well.
  • CHEO will notify your family doctor or pediatrician.

Visiting a child or teen with VRE at CHEO

Before entering your child’s room, you must:

  • Clean your hands with soap and water for 15 seconds. You may also use or alcohol-based hand rub (until dry).

Each time you leave the room, for any reason:

  • Clean your hands with soap and water or alcohol based-hand rub. This stops the spread of VRE to others.

Remember!
Only parents or guardians may visit a patient in isolation. For more information, check our ‘Isolation’ fact sheet.

What will happen if my child has to come back to hospital or to a clinic?

Your child or teen’s electronic health record will have a flag on it to let staff know that they had a previous infection or colonization with VRE. If children or teens with VRE must be re-admitted to CHEO, they will again be isolated and placed on Contact Precautions. They may be re-tested for VRE. For clinic visits, special precautions are not needed, unless your child or teen has signs of an infection (for example, draining wounds, diarrhea, runny nose or cough).

What does VRE mean for home and school life?

The risk to others outside the hospital is very low. A child or teen with VRE does not pose any health risk to family or friends who are well. They should continue with their normal activities. You do not have to tell the school or daycare about VRE. Special precautions are not needed in those settings. It is important for children and teens with VRE to wash their hands often. If you are concerned about your child or teen having VRE, talk to your family doctor or pediatrician.

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