Vre gre

Hello sir, I am Richard John. I am from Hampstead. I want you to help me by providing me some information about the VRE and GRE. Can you give me some information about it?

[Kiran Chandar]

GRE is Glycopeptide resistant enterococci
VRE is Vancomycin resistant enterococci

Significance

Resistance to glycopeptides reduces the options for antibiotic treatment where clinical infection is evident. Resistance in Enterococci can also transfer to other organisms.

Patient Risk Groups
Infections caused by GRE mainly occur in hospital patients, particularly those who are immunocompromised, those who have had previous treatment with certain antibiotics (particularly cephalosporins and glycopeptides), those with a prolonged hospital stay, or those in specialist units such as intensive care or renal units. However, GRE are sometimes found in the faeces of people with no risk factors

Prevention:
Prevention of GRE requires recognised risks to be minimised or avoided.
Appropriate antibiotic prescribing is essential.
Cephalosporins and Vancomycin should be avoided where possible, especially in high risk areas.
Vancomycin should not be used as a first line agent for treating patients with Clostridium difficile diarrhoea or colitis as many of the risk factors for VRE exist in these patients.
As with other organisms, good infection control practice and hygiene are the cornerstone of prevention. This includes appropriate surveillance and isolation of known patients.

Transmission
Within a hospital setting, exogenous transmission usually occurs via the unwashed hands of healthcare workers following contact with colonised or infected patients, their environment or equipment.


Identification of Infection or Colonisation

As colonisation is more common than infection, careful consideration is required when interpreting positive microbiology results. When VRE is isolated from a clinical specimen the following screening of the patient is advised prior to commencing antibiotic therapy:

Stool sample (or, if unavailable, rectal swab)
Wound swabs } Request VRE
Central vascular catheter sites } Screen Only
Catheter specimen of urine
Perineum