Vancomycin-Resistant Enterococci (VRE): Symptoms, Causes, Treatment
What are the symptoms of vancomycin-resistant enterococci?
Vancomycin-resistant enterococci (VRE) are a type of bacteria that have developed resistance to the antibiotic vancomycin. Infections with VRE can cause a range of symptoms, depending on the site of infection. Common symptoms of VRE infections may include:
- Urinary tract infection (UTI): Symptoms may include frequent or urgent need to urinate, pain or burning during urination, cloudy or bloody urine, and pelvic pain.
- Bloodstream infection (bacteremia): Symptoms may include fever, chills, rapid heart rate, and low blood pressure. In severe cases, sepsis may develop, which can lead to organ failure and death if not treated promptly.
- Wound infection: Symptoms may include redness, swelling, warmth, and tenderness at the site of the wound, as well as drainage of pus or other fluids.
- Abdominal infection: Symptoms may include abdominal pain, nausea, vomiting, and diarrhea.
- Endocarditis: Infection of the heart’s inner lining and valves, which can cause symptoms such as fever, fatigue, weakness, shortness of breath, and swelling in the legs or abdomen.
It’s important to note that not everyone who is colonized with VRE (meaning the bacteria are present in the body but not causing an infection) will develop an infection or have symptoms. However, people who are at increased risk for VRE infection include those with weakened immune systems, recent surgery or hospitalization, prolonged antibiotic use, or certain chronic illnesses. If you suspect you have a VRE infection, it’s important to seek medical attention for diagnosis and treatment.
What are the causes of vancomycin-resistant enterococci?
Vancomycin-resistant enterococci (VRE) develop resistance to the antibiotic vancomycin through various mechanisms. The primary causes of VRE include:
- Overuse and misuse of antibiotics: The widespread use of antibiotics, particularly vancomycin, can lead to the development of antibiotic-resistant strains of bacteria like enterococci.
- Prolonged hospital stays: People who are hospitalized for long periods, especially in intensive care units, are at higher risk of acquiring VRE due to increased exposure to antibiotics and other resistant bacteria.
- Use of medical devices: The use of invasive medical devices such as urinary catheters, central venous catheters, and ventilators can increase the risk of VRE transmission and infection.
- Close contact with infected individuals: VRE can be spread from person to person through direct contact or through contact with contaminated surfaces or equipment.
- Healthcare settings: Infections with VRE are more common in healthcare settings such as hospitals and long-term care facilities where there is a higher prevalence of antibiotic-resistant bacteria.
- Underlying health conditions: People with weakened immune systems, underlying medical conditions, or recent surgeries are at higher risk of developing VRE infections.
Preventing the spread of VRE involves infection control measures such as proper hand hygiene, using antibiotics judiciously, and implementing strategies to reduce the transmission of bacteria in healthcare settings.
What is the treatment for vancomycin-resistant enterococci?
Treating vancomycin-resistant enterococci (VRE) infections can be challenging due to the limited availability of effective antibiotics. The choice of treatment depends on several factors, including the site and severity of the infection, as well as the overall health of the patient. Treatment options for VRE may include:
- Other antibiotics: In some cases, other antibiotics that are not affected by VRE resistance, such as linezolid, daptomycin, or tigecycline, may be used to treat VRE infections. However, these antibiotics may have side effects and may not be suitable for all patients.
- Combination therapy: Combining antibiotics with different mechanisms of action may be more effective against VRE. For example, a combination of daptomycin and gentamicin may be used for certain types of VRE infections.
- Fecal microbiota transplantation (FMT): FMT involves transplanting fecal matter from a healthy donor into the colon of a patient with a VRE infection. This procedure can help restore healthy gut bacteria and may be effective in treating recurrent VRE infections.
- Surgery: In some cases, surgery may be necessary to remove infected tissue or to drain abscesses caused by VRE infections.
It’s important to note that not all VRE colonization or infection requires treatment. In some cases, especially if the patient is not showing symptoms, healthcare providers may choose to monitor the situation closely without administering antibiotics.
Prevention is key in managing VRE infections. Healthcare facilities should implement strict infection control measures, such as proper hand hygiene, isolation of patients with VRE, and judicious use of antibiotics, to prevent the spread of VRE and reduce the risk of infections.