What Are MRSA and VRE?
December 30, 2003
Staphylococcus aureus is a common type of bacteria (germ) that is often found in the nose, but can also grow in wounds and other sites of the body, where the infection may cause great harm. Methicillin is an antibiotic or medication that is used to treat these infections. In the early days of antibiotic therapy, Penicillin was used to treat staph infections, but gradually the organism became resistant to most antibiotics except for methicillin. Over time, the bacteria have become resistant to methicillin as well, so this antibiotic is no longer able to kill the germ. If a person has an infection with this germ that cannot be treated with methicillin, the person is said to have Methicillin-resistant Staphylococcus aureus, or MRSA, and must be treated with other antibiotics.
Enterococci are bacteria that are normally found in the bowel and vagina of humans. When they get outside these areas, these bacteria can cause infections of the urinary tract, wounds, or bloodstream. Vancomycin is an antibiotic that usually works to treat these infections. Infections caused by Enterococci that are resistant to Vancomycin are called Vancomycin-resistant Enterococci, or VRE, and are very difficult to treat.
What conditions increase the risk of acquiring these organisms?
People may be carriers or infected with these germs. Carriers means that the germ is present in or on the body but is not causing illness. Infection means that the germ is present and is causing illness. Signs of illness can include fever, elevated white blood cell count, pus, pneumonia, and inflammation (warmth, redness, swelling).
In general, healthy people are at low risk of getting sick with MRSA or VRE. Risk factors for infection include history of using antibiotics; underlying diseases or conditions such as chronic renal (kidney) disease, insulin-dependent diabetes mellitus, peripheral vascular disease, and dermatitis or skin lesions; invasive procedures such as dialysis; presence of invasive devices such as urinary catheters; past hospitalization and long hospital stays; history of having a drug-resistant bacterium; and older age.
How are these germs spread from one person to another?
MRSA is transmitted primarily by contact with a person who has an infection or is a carrier of the bacteria. The germ can be spread by direct contact with the person or by the hands of someone caring for the person touching others before washing hands. MRSA can survive for an hour or more on environmental surfaces such as floors, sinks, blood pressure cuffs, etc. but these are NOT the most likely source of spread.
VRE can be spread person-to-person by the hands of personnel or indirectly on contaminated environmental surfaces and patient care equipment. Studies have found that VRE can live for a long time on hands, gloves and environmental surfaces. For example, the germ has been found after 5-7 days on countertops, 24 hours on bedrails, and 60 minutes on telephone handpieces.
What can be done to prevent the spread, especially in home care settings?
Patients who are carriers or infected with drug-resistant organisms who are discharged to their homes require no special control measures beyond regularly cleaning all surfaces contaminated by secretions or touched by hands. They should be allowed to socialize and participate in normal activities as long as draining wounds are covered, bodily fluids are contained, and good hygiene is practiced. Patients should tell anyone caring for them that they are carriers or infected with a drug-resistant germ.
This article was provided by Seattle Treatment Education Project. It is a part of the publication STEP Ezine.