[Table of Contents]

Canada Communicable Disease Report - Supplement
Volume: 23S8
December 1997

INFECTION CONTROL GUIDELINES

Preventing the Spread of Vancomycin-Resistant Enterococci (VRE) in Canada

Introductory Statement

Table of Contents

List of Participants

Overview of VRE

Epidemiology of VRE

Microbiology of Enterococci

Antibiotic Resistance in Enterococci

Antimicrobial Susceptibility Testing of Enterococci

Risk Factors for VRE

VRE Guidelines Overview

Guidelines for Preventing the Spread of VRE (adapted from HICPAC)

1. Judicious Use of Vancomycin

• Situations in which the use of vancomycin is appropriate or acceptable
• Situations in which the use of vancomycin should be discouraged

2. Educational Program

• Information about VRE and other antibiotic-resistant organisms and their potential impact
• Information about the influence of antimicrobial usage on the emergence of VRE and other antibiotic-resistant organisms

3. Enhancing the Detection and Reporting of VRE in the Microbiology Laboratory

• Identification of Enterococcus species
• Susceptibility testing
• Immediate infection control (IC) notification
• Routine surveillance procedures for detecting VRE where VRE has not been previously detected
• Screening procedures for detecting VRE when a first isolate of VRE has been detected

4. Infection Control Precautions to Prevent the Transmission of VRE in the Health Care Setting

RECOMMENDATIONS

Bibliography

Appendix - Guideline Rating System

VRE Working Group
Canadian Hospital Epidemiology Committee

and

Division of Nosocomial and Occupational Infections
Bureau of Infectious Diseases
Laboratory Centre for Disease Control
Health Protection Branch
Health Canada
Ottawa, Ontario

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