VRE

VRE (Vancomycin-Resistant Enterococcus) Rate Reporting

Enterococcus is a type of bacteria that is normally found in people’s bowels. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. When this bacteria becomes resistant to certain antibiotics it is called VRE. These bacteria can sometimes cause infection.

People with VRE can spread it to others when they forget to wash their hands after using the washroom. It can also be spread by the unwashed hands or on gloves of personnel after direct contact with patients or the contaminated environment. VRE can live in the environment for a long time if not cleaned properly. VRE is not spread through the air by coughing or sneezing.

Patients who contract VRE will be placed under isolation precautions. It is important for all who enter the patient’s room, to follow all of the directions on the precaution sign posted outside the room. Using an alcohol-based hand rub or hand washing before and after contact with any patient is the best way you can help prevent the spread of VRE.

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Rates of VRE Acquired Infections at STEGH

2021

Date
Cases
Rates
January - March 2021
0
0.00

Definitions

The VRE bacteraemia infection rate is calculated as a rate per 1,000 patient days. The total patient days represents the sum of the number of days during which services were provided to all inpatients during the given time frame.

The method of calculation of the VRE bacteraemia infection rate for the reporting period (on a quarterly basis) is:

Number of nosocomial patients with laboratory identification of VRE bacteraemia x 1000
Total number of patient days

Where the numerator is the total number of newly identified cases for VRE bacteraemia associated with the reporting facility, for the reporting period. The denominator is the total number of in-patient days for the reporting period. There are no exclusion criteria.

Sometimes when patients are admitted to the hospital, they get infections while they are in the hospital. This is a hospital-acquired infection or a nosocomial infection. Usually it is MRSA, VRE or C. difficile.

Visit the Ministry of Health Care and Long-Term Care website to view other hospital's rates

If you have any questions about this information or about our hospital’s infection prevention and control program [LINK], please contact us.

STEGH takes your care and your safety very seriously and we are extremely committed to transparency. On a quarterly basis, beginning in December, we will be reporting our infection rates on our website.

FAQ

Enterococci are bacteria that are normally present in the human intestines and in the female genital tract and are often found in the environment. These bacteria can sometimes cause infections. Vancomycin is an antibiotic that is often used to treat infections caused by enterococci. In some instances, enterococci have become resistant to this drug and thus are called vancomycin-resistant enterococci (VRE). VRE have a minimal inhibitory concentration (MIC) to vancomycin of ≥ 32 mcg/ml. They contain the resistance genes VAN-A or VAN-B.

Risk factors for VRE include severity of underlying illness, presence of invasive devices, prior colonization with VRE, antibiotic use and length of hospital stay.

The single most important mode of transmission of VRE in a health care setting is via transiently colonized hands of health care workers who acquire it from contact with colonized or infected patients, or after handling contaminated material or equipment. The unrecognized colonized patient presents a particular risk for transmission to other patients.

STEGH screens (obtains specimens) from all patients who meet set criteria (patients who are at risk of carrying or known to carry MRSA or VRE) in accordance to the best practice document established by the Provincial Infectious Diseases Advisory Committee (PIDAC) upon admission to our hospital. These specimens are sent to the lab for testing.

Treatment depends on how sick patients are with the disease. If a patient develops an MRSA or VRE infection, the physician will review the organism and order appropriate antibiotics to treat the infection. If a patient is identified to be positive for MRSA or VRE but does not have an infection, they will be placed under isolation to prevent the spread.

STEGH has Infection Prevention and Control policies and procedures that align with the PIDAC best practice document that provide the guiding principles for all patient interaction. Those principles include; Routine practice, Hand hygiene at POC, Additional isolation precautions to be put in place with any patient identified with MRSA and VRE. Additional housekeeping practices are put in place to ensure the environment is cleaned appropriately.

STEGH has implemented the ‘Just Clean Your Hands’ hand hygiene program. We audit our compliance with this program and share the results with staff so that we can identify any areas of improvement. STEGH audits our practices for isolation precautions and environmental cleaning to identify any areas for improvement. STEGH ensures patient equipment is dedicated to an isolation room or if needed to be removed is cleaned in accordance to best practice to prevent spread.

Prevention & Control

St. Thomas Elgin General Hospital takes the care and safety of our patients very seriously, and we are committed to transparency, and continuous improvement.

Unfortunately, like many hospitals in Ontario our size, on any given day, in all likelihood, STEGH has patients in isolation with infectious diseases such as VRE. Our focus on patient and staff safety includes a concerted effort in preventing and managing VRE in this facility.

The STEGH Infection Control Committee has supported and recommended a number of strategies to minimize risk as outlined in our policies and procedures.

STEGH uses multiple controls to prevent the spread of VRE, which includes but is not limited to:

  • Hand hygiene facilitation: Alcohol based hand rub (ABHR) has been strategically placed at Point of Care within the patient’s environment so that all care providers can easily access it. STEGH participated in the MOHLTC Just Clean Your Hands pilot and continues to emphasize hand hygiene practice as one of the key components to prevent spread.
  • Education: STEGH staff has been educated on the procedure for managing VRE which is based on the Provincial Infectious Disease Advisory Committee’s (PIDAC) ARO Best Practice Guidelines. Infection Control practices are audited on a regular basis.
  • Use of Personal Protective Equipment (PPE): The use of PPE (gown, and gloves) is required by all who enter the patient environment.
  • Isolation requirements: Our control measures include appropriate patient placement. Patients with VRE will have a ‘Contact’ isolation sign posted outside their room that reviews all necessary instructions that must be followed by all as they enter and exit the patient room. The isolation signage provides a visible communication tool that prompts enhanced environmental cleaning.
  • Tracking VRE: STEGH screens all patients known to have a history of VRE, have risk factors for VRE on admission to our hospital.
  • Environmental cleaning is ongoing using recommended germicides.
    • STEGH conducts daily room cleaning using a special disinfectant.
    • Our cleaning staff is well trained and is dedicated to keeping our hospital clean and safe for our patients.