Vancomycin-Resistant Enterococcus

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Table of Contents

Introduction
History of VRE
Mortality Rate of VRE
Manifestation, Signs, and Symptoms of VRE
Treatment of VRE
Prevention of VRE
Reference List

Introduction

Enterococci bacteria are one of the most common classes of bacteria present in the human digestive system, primarily the intestines. In addition, to the intestines, research studies of the female reproductive system have also revealed the presence of bacteria in the female genital tract. Unlike other bacteria that can thrive in the human body without compromising human health, the Enterococcus bacteria can sometimes pose great health risks to immuno-compromised people, a fact that research studies attribute to the Enterococcus bacteria’s ability to resist antibiotics. Such resistance to the Vancomycin antibiotic, used in most medical cases to treat complications resulting from the bacteria is what bore its present name the Vancomycin-Resistant Enterococcus (VRE). Biologically, there exist six strains of VRE namely Van-A to Van-F, although the prevalent ones are Van-A, Van-B, and Van-C. As research studies show, most Vancomycin-Resistant Bacteria carriers get the bacteria from health institutions, because of the numerous contacts that occur in most health institutions. Common health complications associated with the VRE bacteria include painful wounds, urinary tract infectivity, meningitis, heart valve infections commonly called Endocarditis, and septicemia. Although most of these infections are treatable, VRE bacteria’ ability to resist most antibiotics makes the bacteria a great threat to human health, because of the lethal nature of antibiotic injections used to treat serious health complications caused by VRE (Cetinkaya, Falk, & Mayhall, 2000, pp. 686-694).

History of VRE

The presence of the Enterococcus bacteria in body systems is a normal phenomenon, although in some cases colonization can cause several health complications. The most susceptible individuals to health complications associated with VRE include frequent users of vancomycin, individuals hospitalized for extended durations, those with a weak body defense mechanism, and most individuals who have undergone surgery (primarily chest and abdominal surgeries). VRE is not an air-borne disease, but rather its primary mode of transmission is through contact with contaminated bodies, for example, body fluids and the human stool (Fraser, LIM, Donskey, & Salata, 2002, p.1).

Medical researchers discovered the first form of VRE in 1986 in France, although at that time there were no proper medical methods of isolating the bacteria. In an endeavor to understand VRE better in 1987, through more medical researches UK doctors were able to isolate the first strain of VRE. In the United States, medical researchers discovered the first strains of VRE in 1989 hence, making VRE major governmental health, because of the rapid increase in numbers of individuals whose medical tests showed they had VRE. For example, between 1989 and 1993, there was a more than 7.6 percent increase in the number of individuals with VRE, from the previous 0.3% in 1986 (Edmond, Ober, Dawson, Weimbaum, &Wenzel, 1996, pp. 1243-1235). Such tremendous increases were also evident in 2003, with a reported prevalence of more than 28 % of individuals suffering from complications associated with VRE. Such tremendous increases over time have led to more medical researches aimed at discovering the genetic makeup of the bacteria; hence, the present methods of combining antibiotics to deal with VRE. Although medics since then have tried to come up with methods of treating VRE, still VRE is one of the primary causative agents of nosocomial health complications, a fact supported by the increased numbers of patients with VRE. In the present U.S. as research studies show, approximately 20% of patients under Intensive Care Unit support suffer from medical complications associated with VRE (Rice, 2001, pp.1)

Mortality Rate of VRE

More than 60% percent of individuals diagnosed with VRE-associated health problems die annually in the United States, a number that increases with the nature of an individual’s health condition. For example, more than 50% of individuals with tumor and transplant complications die annually, a fact that research studies attribute to the resistant nature of VRE to most antibiotics. Such resistance to antibiotics has made VRE be among the leading causative agent of nosocomial health complications (Edmond, Ober, Dawson, Weimbaum, &Wenzel, 1996, pp. 1243-1235).

Manifestation, Signs, and Symptoms of VRE

Depending on the infected body part, the VRE manifests itself differently. In addition, in most cases, most individuals may fail to recognize its VRE, because of the close resemblance of its symptoms with many common health complications. Common symptoms associated with VRE include elevated body temperatures, diaphoresis, breathing complications, queasiness, diarrhea, extreme abdominal pains, dysuria, and wound infectivity. In addition, most individuals with a urinal tract infection will feel a continuous urge to urinate or an itchy feeling when urinating, although they may fail to do so when they attempt (Fraser, LIM, & Donskey, 2002, p.1).

Treatment of VRE

Because of the resemblance nature of VRE symptoms with other medical complications, the only way of diagnosing VRE is through medical screening. Depending on the lab test results, which are the primary mechanisms of knowing the antibiotics that VRE is resistant to, doctors will prescribe a combination of antibiotics that will clear the bacteria from the affected areas. The most commonly used antibiotics include QuinuPristin-Dalfopritism, daptomycin, pristinamycin, sparfloxacin, and MInocycline. Although some doctors may recommend penicillin or ampicillin, some strains of VRE are resistant to these antibiotics, making it necessary to prescribe other antibiotic combinations (Raad, Hachem, Hanna, Girgawy, Rolston, Whimbley, Husni, & Bodey, 2001, pp. 3202-3204 and Bethea, 2004, pp.989-991).

Prevention of VRE

Because the primary mode of VRE transmission is being in contact with infected wounds or fluids, it is important for individuals handling patients, for example, nurses and caretakers to maintain high standards of hygiene or wear protective gloves when dealing with VRE patients. In addition, to avoid chances of contracting urinary tract infections, women must wipe themselves properly immediately after urinating. For individuals with Foley catheters, maintaining high hygiene conditions is the only way of Preventing VRE from contaminating their wounds (Goldman, Weistein, & Wenzel, et al., 1996, pp. 234-239)

Reference List

Bethea, J. A. (2004). Treatment of vancomycin-resistant Enterococcus with Quinupritism/ DAlfopristin and high dose Ampincilin. The Annals of Pharmacology, 38(6), 989-991. Web.

Centikaya, Y., Falk, P., & Mayhall, G. C. (2000). Vancomycin-Resistant Enterococci. Clinical Microbiology Reviews, 13(4), 686-707. Web.

Edmond, M. B., Ober, J. F., Dawson, J. D., Weinbaum, D. L., & Wenzel, R. P. (2002). Vancomycin Resistant Enterococcal Bacteremia: Natural history and and attributable mortality. Clinical Infectious Diseases, 23(6), 1234-1239.

Fraser, S. L, LIM, J., & Donskey, C. J., Salata, R. A. (2002). Enterococcal infections. Webmed. Web.

Goldman, D. A. Weistein, R. A., & Wenzel, R. P., et al. (1996). Strategies to prevent and and control the emergency and spread of antimicrobial-resistant microorganisms In hospitals, JAMA, 275 234-240.

Raad, I., Hachem, R., Hanna, H., Girgawy, E., Rolston. E., Whimbley, E., Husni, R., &Bodey, G. (2001). Treatment of Vancomycin-Resistant Enterococcal Infections in the immune-compromised host: Quinipritism-Dalfopritism in Combination with Minocline. Antimicrobial Agents and Chemotherapy, 45(11), 3202-3204. Web.

Rice, L. B. (2001). Emergence of Vancomycin Resistant Enterococcus. Emerging Infectious Diseases, 7(2), 1.

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