Intestinal Colonization of Enterococcus mundtii ST4SA and ...
Vancomycin resistant enterococcus (VRE) · It is important that healthcare workers and visitors...
Transcript of Vancomycin resistant enterococcus (VRE) · It is important that healthcare workers and visitors...
Is my family at risk if I have become colonized with VRE?
• VREisnomoredangerousthanothernormalbacteriathatpeoplecarryontheirskinandareexposedtoeveryday
• Youcancarryonwithyourusualactivitiesandremindeveryonetowashtheirhandsoften.Youshouldwashyourhandsafteryougotothebathroomortouchanywoundsasamatterofroutine,notjustforVRE
Ifafamilymemberassistsinpatientcare,nursingstaffwillinformthepersonsinvolvedofanyextraprecautionsnecessary
Personsvisitingshouldbeawareoftheirownhealthstatussoastoavoideitherputtingthepatientatincreasedriskorthemselvesatrisk
Itisnotrecommendedtovisitanypatientifyouarefeelingunwell,forexample,ifyouhavevomiting/Diarrhoeaorflulikesymptoms
Can a patient go home with VRE?
HavingVREisnotareasonforremaininginhospital,onceapatientisotherwisefitfordischarge.AnynecessaryfollowupwillbearrangedwiththepatientsGPorpublichealthnurse
What will happen in the future if the patient needs to go to hospital?
IfapatientattendsanyhospitalinthefuturetheyshouldinformmedicalandnursingstafftherethattheyhavehadVRE.Swabsandotherspecimenswillbetakenforlaboratoryanalysis.
ForfurtherinformationpleasecontacttheinfectioncontrolteaminBlackrockClinic.
Compiled by Joanne Flanagan, Clinical Nurse Specialist, Infection Prevention and Control
Authorised by Dr Anne Gilleece, Consultant MicrobiologistPublished date August 2009 Last reviewed August 2009
Blackrock Clinic Rock Road, Blackrock, Co. Dublin Tel: 01 2832222 Fax: 01 2064314
www.blackrock-clinic.com
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AccreditedbyJointCommissionInternational
Information and Advice for Patients and Visitors
Vancomycin resistant enterococcus (VRE)
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What are enterococci?
•Enterococciaremostcommonlyfoundinthebowelsofmostanimals,includinghumans,wheretheymakeuppartofthenormalbacterialflora.Theycanalsobefoundinthehumangenitaltract
• Theyarehardymicroorganismsthatcansurvivetheharshestenvironmentsandcanbefoundinsoil,waterandonvegetation
• Mostpeoplewhocarryenterococcidon’tsufferanyilleffects.Carryingenterococciharmlesslylikethisiscalled“colonisation”
• Sometimesenterococcicauseinfectionsiftheyenterthebody.Thisismorelikelytohappentopeoplewhoarealreadyunwell,particularlythosewhoareinhospitalwithaseriousillness
• Therearemanydifferentspeciesofenterococci,butonlyafewhavethepotentialtocauseinfectionsinhumans.Morethan95%ofinfectionsduetoenterococciarecausedbyjusttwospecies,EnterococcusfaeciumandEnterococcusfaecalis
What type of infections do enterococci cause?
• Mostpeoplewhocarryenterococcidon’tsufferanyilleffects
• Enterococcicancausearangeofdifferentinfectionsincluding:
oWoundinfections
oUrinarytractinfections
oInfectionsoftheabdomenandpelvis
oInfectionsinthebileduct(cholangitis)
oHeartvalveinfection(endocarditis)
oBacteraemia(infectionoftheblood)
What are vancomycin-resistant enterococci (VRE)?
Vancomycin-ResistantEnterococci(VRE)areenterococcithathavebecomeresistanttovancomycin.
Are some people more at risk than others?
• MostpeoplewhocarryVREdon’tsufferanyilleffects
• VREcolonisationandinfectionsmainlyoccurinhospitalpatients
• CertainpeopleareatincreasedriskofVREcolonisation.Theseincludepatients:
Thatarecurrentlyonorhaverecentlytakenvancomycinorotherantibiotics(includingcephalosporins,ciprofloxacin,aminoglycosides,clindamycinandmetronidazole)foranextendedperiod
Withconditionsthatcompromisetheimmunesystem(e.g.cancerchemotherapy)
Whohavespentalongtimeinhospitalorotherhealthcaresetting
Whohaveundergonesurgicalprocedures,especiallyabdominalorchestsurgery
Whohavealong-termindwellingcatheter(e.g.intravenousorurinarycatheters)
Inspecialistunitssuchasintensivecareorrenalunits
• However,VREaresometimesfoundinthefaecesofpeoplewhohaveneverbeeninhospitalorhavenotrecentlybeengivenantibiotics
How is VRE spread?
• VREismostcommonlyspreadbydirectHANDcontactwithapersoncolonisedorinfectedwithVREorindirectlyviathehandsofhealthcareworkers
• VREisalsospreadbytouchingcontaminatedsurfaces(e.g.railings,doorhandles)thathavebeencontaminatedbysomeonewhohasnotwashedtheirhands
• SomeinfectionsoriginatefromVREthatmaybepatient’sownnormalbacterialflora
VRE is NOT passed through the air or by coughing
Hand washing is critical to prevent the spread of VRE
Is VRE treatable?
HealthypeoplewhocarryVREintheirbodies(colonization)donotneedtreatment.
Patientswithindwellingcatheterswhohavedevelopedinfectionsduetoenterococci/VREmayneedtohavethecatheterremoved.Antibiotictherapymaybeneededforseriousinfections.
ThosewithVREinfections(e.g.bacteraemia)willbetreatedwithotherantibiotics
How can VRE spread be controlled?
• VREismostcommonlyspreadviahands,equipment,andsometimestheenvironment
• Goodhygienemeasures(frequenthand-washingandcleaningoftheenvironment)shouldbepracticedatalltimestopreventthespreadofVRE(andothermicroorganisms)frompersontoperson.GlovesandgownsshouldbewornifsomeoneisincontactwithbodyfluidsthatmaycontainVRE(e.g.faeces)
• HandwashingisthebestwaytopreventthespreadofVRE
• ApatientfoundtobecolonisedwithVREwillbeisolatedandcaredforusingbarrierprecautions,suchasapronsandgloves
The most important ways to prevent and control VRE are:
1. Handwashing
Itisimportantthathealthcareworkersandvisitorswashtheirhandsbeforeandaftervisitingapatient.Providedhandsarenotsoiled(whentheyshouldbewashedwithsoapandwater),alcoholgelscanbeused
2. Sensible antibiotic prescribing
Onlyprescribecertainantibioticsincludingvancomycin,tothosepatientswhoreallyneedthem
3. Good environmental cleaning and decontamination practices
4. Staff education on how to recognise and control VRE
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