What Are VRE? Symptoms, Causes, Diagnosis, Treatment, and Prevention

VRE stands for vancomycin-resistant enterococci.

Vancomycin is an antibiotic that is commonly used to treat these infections, but as with a number of other bacteria that have developed antibiotic resistance — the ability of certain germs to fight off the drugs that have been formulated to kill them — enterococci has learned to adapt and prevail against the drug. These hard-to-kill bacteria are called vancomycin-resistant enterococci (VRE).

To understand how antibiotic-resistant bacteria such as VRE emerges, it helps to first understand how bacteria and fungi change in response to medicines designed to kill them. According to the CDC Antibiotic Resistance Threats Report, germs naturally evolve constantly, and can develop new ways to avoid the effects of antibiotics. Once that happens, the resistant germ survives and multiplies, and the surviving germs, which now have resistance traits in their DNA, pass on this genetic information to subsequent generations. These resistant germs can continue to spread and pose an increasing threat to people’s health.

VRE are most commonly found in healthcare settings such as nursing homes or hospitals, particularly in areas where there are people with weakened immune systems such as intensive care units or cancer or transplant wards. VRE can cause infections in patients and then spread to others when the patient is transferred to another facility or goes home.

If you are healthy, your chances of getting sick from VRE are very low, even if you have been exposed to the bacteria. But if you have a weakened immune system, that can be a very different story.

People who are more likely to have VRE include:

• Those who have been treated with antibiotics, including vancomycin (particularly for long periods of time)
• Individuals who have been hospitalized (particularly if you had surgery or have had medical devices such as catheters inserted into your body)
• People who have weakened immune systems, such as those who have a long-term illness or are in intensive care units or cancer or transplant wards of a hospital

How long you have a VRE infection can depend on how serious it is and how well it responds to treatment.

• Bacteremia (bacterial infection that has spread to the bloodstream)
• Urinary tract infection
• Endocarditis (infection of a heart valve)
• Meningitis
• Wound infection
• Pneumonia
• Intra-abdominal infections (such as peritonitis)
• Pelvic infections
• Skin and soft tissue infections

• Bacterial sepsis
• Other hospital-acquired infections
• Endocarditis
• Peritonitis and abdominal sepsis
• Septic arthritis
• UTI
• Wound infection

Centers for Disease Control and Prevention (CDC)

The CDC is leading the charge against antibiotic-resistant pathogens such as VRE. This page details important information about what VRE is and how we can protect ourselves from this and other antibiotic-resistant germs that threaten our health. It also links to the 2019 Antibiotic Resistance Threats Report, which lays out useful and important information about VRE and other dangerous bacteria that should be on everyone’s radar.

MedlinePlus

This site from the U.S. National Library of Medicine offers essential information about who is at risk for VRE and how to prevent the spread of this potentially dangerous, even deadly bacteria.

Michigan Medicine

University of Michigan’s Michigan Medicine explains in simple, jargon-free language exactly why VRE is a problem; what we need to know about basics such as how it’s spread, diagnosed, and treated; and, most importantly, how to prevent it.

Additional reporting by Joseph Bennington-Castro.