[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

Risk Factors for VRE

Studies to date suggest that certain patient populations are at increased risk of VRE infection and colonization. Patients (both adult and pediatric) from critical care units, hematology-oncology wards, dialysis units, or transplantation units, or patients who have had major intra-abdominal or thoracic procedures appear to be at higher risk than other populations^(38,57-61). Several studies have identified risk factors for VRE infection and/or colonization. These factors include previous antibiotic therapy, multiple antibiotic therapy, vancomycin therapy, indwelling foley catheters, central venous catheterization, renal insufficiency, increased duration of hospital stay, multiple hospital admissions, and the elderly population^{(15,16,18,38-40,42,43,62-67)}. These studies have demonstrated the transmission of VRE by direct patient contact or by carriage on the hands of health care personnel, contaminated environmental surfaces and contaminated patient care equipment. Environmental contamination is attributed largely to heavy shedding as may be more often seen in patients with diarrhea or fecal incontinence, or uncontained draining wounds. Studies have documented the carriage of high-level aminoglycoside-resistant enterococci in medical personnel and residents of extended care facilities^(68,69).

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