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Vancomycin-resistant Enterococcus faecium (VRE) is a formidable superbug that poses a significant threat in healthcare settings. This bacterium has evolved to resist vancomycin, an antibiotic traditionally used as a last resort for treating serious infections. Understanding VRE is the first step for healthcare providers, facility managers, and janitorial staff to effectively control its spread and protect vulnerable individuals.

What is Vancomycin-Resistant Enterococcus Faecium (VRE)?

Enterococcus faecium is a type of bacteria that normally lives harmlessly in the human intestines and female genital tract. However, it is an opportunistic pathogen, meaning it can cause serious infections if it enters other parts of the body, such as the bloodstream, urinary tract, or surgical wounds.

VRE is a specific strain of Enterococcus faecium that has acquired genetic resistance to vancomycin. This resistance makes VRE infections particularly difficult to treat, often requiring complex and less-effective alternative antibiotics. Its resilience and ability to survive on surfaces for extended periods make it a major concern for infection control in high-traffic environments.

Where is VRE Commonly Found?

VRE thrives in healthcare environments where antibiotic use is high and patients have weakened immune systems. It is a leading cause of hospital-acquired infections (HAIs).

Key environments and surfaces where VRE is frequently found include:

• Hospitals and Long-Term Care Facilities: VRE is notorious for colonizing patient rooms, intensive care units (ICUs), and surgical wards.
• High-Touch Surfaces: Bed rails, overbed tables, doorknobs, medical equipment (like blood pressure cuffs and stethoscopes), and bathroom fixtures are common reservoirs for VRE.
• Medical Devices: Catheters, ventilators, and other invasive devices can introduce VRE directly into a patient's body, leading to severe infections.
• Shared Equipment: Wheelchairs, walkers, and rehabilitation equipment can easily become contaminated and facilitate cross-transmission between patients if not properly disinfected.

The bacterium can be carried on the hands of healthcare workers, visitors, or patients, and spreads easily through direct contact or by touching contaminated surfaces.

Health Risks Associated with VRE

While healthy individuals are rarely affected by VRE, it poses a grave danger to those with compromised health. The primary risks include:

• Difficult-to-Treat Infections: VRE can cause a range of serious infections, including bloodstream infections (bacteremia), urinary tract infections (UTIs), surgical site infections, and endocarditis (infection of the heart lining).
• Antibiotic Resistance: The core danger of VRE is its resistance to vancomycin. This limits treatment options, leading to longer hospital stays, increased healthcare costs, and higher mortality rates.
• Transmission: VRE is primarily spread through contact. This can happen from person-to-person (often via unwashed hands) or by touching a surface contaminated with the bacteria and then touching your mouth, nose, or an open wound.

Patients who are elderly, have weakened immune systems, have recently undergone surgery, or have indwelling medical devices are at the highest risk of developing a VRE infection.

How to Kill and Control VRE

Controlling VRE requires a multi-faceted approach centered on stringent cleaning and disinfection protocols. Since VRE can survive on dry surfaces for weeks, simply cleaning is not enough—disinfection is mandatory.

1. Thorough Cleaning: Before disinfection, all surfaces must be thoroughly cleaned to remove organic matter (like dirt, blood, or bodily fluids). Disinfectants cannot work effectively if they are applied to a dirty surface.
2. Use an EPA-Registered Disinfectant: Select a disinfectant that is EPA-registered and has a specific claim against VRE. Disinfectant wipes are often preferred for high-touch surfaces because they are pre-saturated with the correct chemical concentration, reducing the risk of human error.
3. Adhere to Dwell Time: Dwell time is the most critical factor in disinfection. It is the amount of time a disinfectant must remain wet on a surface to kill the pathogen. For VRE, this can range from 30 seconds to 10 minutes, depending on the product. Wiping the surface dry before the full dwell time has elapsed will not kill the bacteria.
4. Focus on High-Touch Points: Pay special attention to frequently touched items like bed rails, call buttons, remote controls, light switches, and medical equipment between each patient use.
5. Hand Hygiene: Strict hand hygiene protocols for all staff, patients, and visitors are essential to prevent the spread of VRE.

Who Should Be Concerned?

Specific professional groups must be particularly vigilant about VRE control:

• Healthcare Providers (Doctors, Nurses): As the front line of patient care, they must practice impeccable hand hygiene and ensure all medical equipment is disinfected.
• Janitorial and Environmental Services (EVS) Staff: This team is responsible for the daily battle against VRE. They need proper training on cleaning protocols, dwell times, and the use of EPA-registered disinfectants.
• Infection Control Practitioners and Facility Managers: These leaders are responsible for establishing, enforcing, and auditing cleaning policies to ensure compliance and patient safety.

Ultimately, preventing the spread of VRE is a collective responsibility. By implementing and following strict disinfection practices with proven products, healthcare facilities can significantly reduce the risk of VRE transmission and protect their most vulnerable patients.

For effective surface disinfection against a broad spectrum of pathogens, including tough superbugs like VRE, we recommend using disinfectant wipes from a trusted supplier. Wipes.com offers a range of EPA-registered disinfecting wipes suitable for healthcare settings, ensuring you have the right tools to maintain a safe and hygienic environment.