Vancomycin-Resistant Enterococci (VRE)
Bacteria infecting children in hospital intensive-care units that resist vancomycin, the most powerful antibiotic available. Vancomycin-resistant enterococci (VRE) infection represents an increasing public health concern.
Enterococci normally live in the stomach and intestines and on the skin; generally they do not cause disease, but they can cause infections (especially in children weakened by another illness). What makes these particular bacteria so dangerous is that many strains are able to resist antibiotics, including penicillins, cephalosporins, and aminoglycosides. As a result, for many years doctors relied on vancomycin to treat serious enterococcal infections.
In the late 1980s, however, strains of enterococci began to appear that resisted even this drug of last resort. They now cause 10 percent of all hospital-acquired infections. VRE were first documented in Europe in the 1980s and are now emerging as a new threat to patients in the United States.
In 1993 infection with enterococci bacteria occurred in about three or four cases per 10,000; of these, about 14 percent were resistant to vancomycin. As many as 73 percent of patients who contract VRE die.
Recent information suggests that in the United States, VRE are most commonly found in teaching hospitals and hospitals with more than 500 beds. Reports also suggest that it is rare for a patient who has not been in a hospital to have VRE. However, in Europe VRE can be found in waste waters and in the feces of both nonhospitalized patients and healthy volunteers.
In one recent study reported in the British medical journal Lancet, researchers found that of 38 patients admitted to intensive care, nine brought the infection with them, 12 became infected on the unit, and one person who had one strain of the bacteria on admission developed a second different variety while hospitalized. Of these 13, 11 were infected by a strain that had spread from another patient.
There is no proven treatment for VRE; the infection is transmitted by hand contamination. Chlorhexidine (but not regular soap) kills the bacteria.
Because VRE can live on telephones, walls, and patient charts, hospitals are trying to improve housekeeping and make sure all health-care workers wash their hands often. Moreover, doctors should not prescribe antibiotics for viral illnesses (such as colds) or in low doses or for just a few days. Weak prescriptions simply slow down the germs and help create superbugs.
Enterococci normally live in the stomach and intestines and on the skin; generally they do not cause disease, but they can cause infections (especially in children weakened by another illness). What makes these particular bacteria so dangerous is that many strains are able to resist antibiotics, including penicillins, cephalosporins, and aminoglycosides. As a result, for many years doctors relied on vancomycin to treat serious enterococcal infections.
In the late 1980s, however, strains of enterococci began to appear that resisted even this drug of last resort. They now cause 10 percent of all hospital-acquired infections. VRE were first documented in Europe in the 1980s and are now emerging as a new threat to patients in the United States.
In 1993 infection with enterococci bacteria occurred in about three or four cases per 10,000; of these, about 14 percent were resistant to vancomycin. As many as 73 percent of patients who contract VRE die.
Recent information suggests that in the United States, VRE are most commonly found in teaching hospitals and hospitals with more than 500 beds. Reports also suggest that it is rare for a patient who has not been in a hospital to have VRE. However, in Europe VRE can be found in waste waters and in the feces of both nonhospitalized patients and healthy volunteers.
In one recent study reported in the British medical journal Lancet, researchers found that of 38 patients admitted to intensive care, nine brought the infection with them, 12 became infected on the unit, and one person who had one strain of the bacteria on admission developed a second different variety while hospitalized. Of these 13, 11 were infected by a strain that had spread from another patient.
There is no proven treatment for VRE; the infection is transmitted by hand contamination. Chlorhexidine (but not regular soap) kills the bacteria.
Because VRE can live on telephones, walls, and patient charts, hospitals are trying to improve housekeeping and make sure all health-care workers wash their hands often. Moreover, doctors should not prescribe antibiotics for viral illnesses (such as colds) or in low doses or for just a few days. Weak prescriptions simply slow down the germs and help create superbugs.
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