Vancomycin-resistant enterococcal bacteremia
Overview
A condition which is characterised by bacteremia caused by an enterococci that is resistant to vancomycin.
Symptoms
* Fever * Tachypnoea * Prolonged capillary refill * Hypothermia * Tachycardia * Hypotension * Diarrhoea * Cool extremities * Hypoxemia * Clammy extremities * Shortness of breath * Diaphoresis * Nausea * Vomiting * Abdominal pain * Coma * Rash * Delirium * Dysuria * Abdominal tenderness * Flank pain * Confusion
Causes
VRE enters health care facilities through an infected or colonized patient or a colonized health care worker. It can also develop following treatment with vancomycin. VRE spreads through direct contact between the patient and caregiver or between patients. It can also spread through patient contact with contaminated surfaces such as an overbed table where it's capable of living for weeks. VRE has also been detected on patient gowns, bed linens, and handrails.
Diagnosis
* Cold & Flu: Home Testing: Home Fever Tests Home Ear Infection Tests Home Flu Tests
Treatment
New antimicrobials, such as linezolid and quinupristin and dalfopristin, are available for treatment of VRE infection. Patients who are already colonized with VRE usually aren't treated with antimicrobials. Instead, the physician may stop all antibiotics and simply wait for normal bacteria to repopulate and replace the VRE strain. Combinations of various drugs may also be used, depending on the source of the infection. To prevent the spread of VRE, some facilities perform weekly surveillance cultures on at-risk patients in the intensive care or oncology units and on patients who have been transferred from a long-term care facility. Any colonized patient is then placed in contact isolation until culture-negative or until discharged. Colonization can last indefinitely; no protocol has been established for the length of time a patient should remain in isolation.