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Web site spotlight: Preventing the spread of vancomycin-resistant enterococci

Staff Development Weekly: Insight on Evidence-Based Practice in Education, June 26, 2008

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Vancomycin-resistant enterococci (VRE) spends far less time in the spotlight than other multidrug-resistant organisms (MDROs), particularly MRSA. Although this organism may be less pathogenic than some of its more famous counterparts, it still poses a serious concern for healthcare facilities. Not only does VRE cause complications for already sick patients, resulting in longer stays and higher costs, but there is another concern-chiefly that it will meet with MRSA in a co-colonized patient and mutate, spreading vancomycin-resistant Staphylococcus aureus (VRSA), says Connie Steed, RN, BSN, CIC, manager of IC at the Greenville (SC) Hospital System.

Assessing your facility's risk

VRE was first reported in U.S. hospitals in 1989. By 2004, data showed that VRE caused about one-third of infections in hospital ICUs, the CDC states. According to the CDC, VRE infections most commonly occur in patients who:

• Are treated with vancomycin and combinations of other antibiotics, such as penicillin and gentamicin
• Receive antibiotic treatment for long periods of time
• Have weakened immune systems, such as patients in ICUs or in cancer or transplant wards
• Have had surgery, such as abdominal or chest surgery
• Use medical devices, such as urinary catheters or central intravenous catheters, that stay in for a long period of time

Editor's note: This excerpt was taken from the article "Strategies to prevent the spread of vancomycin-resistant enterococci in your facility," found in the Reading Room at www.StrategiesForNurseManagers.com. Get a free trial membership that will give you 30 days to test drive all the exciting features on the Web site.

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