Enterococcus is a bacteria (or germ) that many people have in their intestines (gut) and urinary system without it causing illness. This is known as colonisation. However, enterococcus can sometimes invade other parts of the body and cause infection.
VRE are resistant to Vancomycin which is a strong antibiotic used to treat infections.
Who is at an increased risk of getting a VRE infection?
Children in hospital who:
- have been treated previously with Vancomycin or other antibiotics for long periods of time.
- have weakened immune systems such as intensive care patients, or those in cancer or transplant wards.
- have had surgical procedures such as abdominal or chest surgery.
- have internal medical devices that stay in for some time such as feeding / PEG tubes or central intravenous (IV) catheters.
- are colonised with Enterococcus.
How is VRE spread?
VRE is spread from person to person by direct contact or by touching surfaces with VRE on them, such as bed and cot rails, medical equipment, door handles and bathroom fixtures.
VRE is not usually spread through the air by coughing or sneezing.
Why is it important to identify VRE?
VRE can cause infections of the urinary tract, bloodstream or wounds. VRE-caused infections are uncommon but are more difficult to treat. We do not want VRE to become widespread.
How is VRE diagnosed?
VRE is detected by testing wound swabs, and urine and faeces samples in a laboratory.
Why is my child being screened or tested for VRE?
- To protect your child (especially if they are going to have surgery) and provide the right treatment if they do develop VRE infection.
- To protect other children, especially those having procedures where VRE may cause problems.
At Queensland Children’s Hospital, we do routine screening which involves taking a sample or swab from children who are at risk of having VRE, such as children in oncology, intensive care, rehabilitation, those transferred from other health care facilities, children with burns or who have had a transplant such as liver or renal transplant, or children on long-term antibiotics.
How is VRE treated?
Most VRE infections can be treated with antibiotics other than Vancomycin. Laboratory testing of the VRE can determine which antibiotics will work.
If your child is colonised with VRE, and does not have an infection, no treatment is needed. However, it is good to be aware of this so you can advise health care workers if your child is going to be treated or admitted to hospital.
How can you prevent the spread of VRE?
While your child is in hospital, it is very important that you, your child, hospital staff and your visitors use excellent hand hygiene practices. This means using an alcohol-based hand rub or washing with soap / antiseptic and water to clean your hands. This needs to be completed frequently and thoroughly to reduce the risk of spreading this germ. It is particularly important that you and your child perform hand hygiene after going to the toilet / changing nappies or touching areas where the VRE may be.
When should you clean your hands?
Always clean your hands:
- before handling anything that goes in the mouth.
- before preparing or eating food or drinks.
- after going to the toilet or changing nappies.
- after using a tissue or handkerchief.
- after handling rubbish.
- after handling dirty washing.
- after coming into contact with an affected area (avoid touching wherever possible).
- before leaving a patient’s room.
What other precautions are taken?
Our staff will use special precautions to stop the spread of VRE to other children. Your child may stay in a single room or share a room with a child with the same germ. Your child will be asked to stay in their room, unless they are receiving tests and treatment.
Our hospital staff will use gloves and gowns/aprons while caring for your child – this is commonly known as ‘contact precautions’. Our staff wear gloves and gowns so they don’t spread VRE to other children in the hospital.
If your child has VRE can they have visitors?
VRE can affect people who have certain long-term health problems. Please let the nursing staff know if someone who has a long-term health problem wants to visit your child. Visitors will be asked to wash their hands after visiting your child, so that they do not spread this to others.
You and your visitors don’t usually need to wear gloves or gowns unless you or they will be visiting others in the hospital.
What happens when you visit the hospital outpatient department or return to the hospital after discharge?
As there may be other children there who are at high risk of infection, precautions will still be put in place when you visit outpatient clinics or day units, come to the emergency department or are re-admitted to hospital. This may involve using a single room or allocating a time slot for appointments or procedures when there are fewer patients. Please let staff know that VRE precautions are required.
Do I have to tell my child’s school, pre-school / kindergarten, or other parents?
No. The risk to others outside a hospital environment is very low. Regular hand washing is the most important factor in preventing spread of VRE. However, if your child has long-term treatment (e.g. cancer, haemodialysis,) there may be some restrictions on camps or gatherings with other children with the same illness. Please speak to our staff about this.
Can the VRE be cleared?
Some children can be cleared of VRE. This depends on the use of antibiotics, if they have any drains / tubes or devices and if they have any ongoing health conditions. Your child’s care team or the infection control nurses will be able to advise you.
Infection Management and Prevention Service
Queensland Children’s Hospital
501 Stanley Street, South Brisbane 4101
t: 07 3068 4145 (nurses)
t: 07 3068 1558 (administration)
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.