To avoid spreading VRE from person to person, it is important to wash or decontaminate hands frequently, including before and after touching the patient or his/her environment. In the hospital, staff will also wear gowns and gloves when caring for a person with VRE.
The risk of VRE infection can be reduced by minimizing the use of indwelling devices such as intravenous lines and urinary catheters. The risk is also reduced by eliminating inappropriate use of antibiotics.
Most microbiological laboratories will supply the physician treating the patient with a list of antibiotics the VRE are resistant and susceptible to. If the laboratory does not or cannot provide an alternative antibiotic for VRE treatment, the state lab or the CDC should be notified as they may be able to provide additional help and suggestions for treatment.
Linezolid, daptomycin, tigecycline, oritavancin, telavancin, quinupristin-dalfopristin and teicoplanin (not available in the U.S.) are antimicrobials that have been used with success against various VRE strains. Clinicians have also had some success in treating VRE with various combinations of antibiotics. However, VRE antibiotic susceptibility tests done for each infection should help guide the selection of treatment protocols. In addition, consultation with an infectious-disease expert is usually done.
Other procedures can augment the antimicrobial treatment of VRE-infected patients. If there is a collection of pus, such as an abscess, it is important that it be drained. If the infection is associated with an intravenous line, the line should be removed if at all possible. Similarly, it is desirable to remove urinary catheters to facilitate treatment of the urinary tract infection. Patients who are colonized but not infected do not require treatment. There is no established way to eradicate colonization of the stool once it occurs.
People infected with VRE need to be treated by medical caregivers; there is no home remedy for VRE infections.
