{"id":1708,"date":"2016-07-15T13:59:54","date_gmt":"2016-07-15T17:59:54","guid":{"rendered":"https:\/\/www.bu.edu\/research\/?page_id=1708"},"modified":"2024-06-13T11:41:47","modified_gmt":"2024-06-13T15:41:47","slug":"vancomycin-resistant-enterococcus-vre-agent-information-sheet","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/research\/ethics-compliance\/safety\/rohp\/agent-information-sheets\/vancomycin-resistant-enterococcus-vre-agent-information-sheet\/","title":{"rendered":"Vancomycin-resistant Enterococcus (VRE) Agent Information Sheet"},"content":{"rendered":"

Boston University
\nResearch Occupational Health Program (ROHP)
\n617-358-7647<\/span><\/p>\n

Agent<\/h2>\n

Enterococcus <\/em>spp. is facultatively anaerobic, catalase-negative Gram-positive cocci bacterium that are arranged individually, in pairs, or short chains. Vancomycin-resistant Enterococci VRE are those enterococci that are resistant to the antibiotic vancomycin. E. faecalis <\/em>is the most frequent species isolated from human intestine samples (80-90%), E. faecium <\/em>accounts for 5-10% of isolates.<\/p>\n

Disease\/Infection<\/h3>\n

Enterococci <\/em>can cause urinary tract, wound, and soft tissue infections. They are also associated with bacteremia which can lead to endocarditis in previously damaged cardiac valves.<\/p>\n

Pathogenicity<\/h3>\n

<\/strong>Enterococci are opportunistic pathogens which affect elderly patients with underlying disease and other immunocompromised patients who have been hospitalized for long periods, treated with invasive devices, or received broad-spectrum Enterococci are common nosocomial pathogens, accounting for 10% of hospital- acquired infections in the USA.<\/p>\n

No laboratory acquired cases have been reported; however, 78 cases with 4 deaths associated with Streptococcus <\/em>spp. were reported before E. faecalis <\/em>and E. faecium <\/em>were placed in the Enterococcus <\/em>genus.<\/p>\n

Biosafety Information<\/h3>\n

Risk<\/strong> <\/span>Group\/BSL
\n<\/strong>Risk Group 2
\nBiosafety Level 2<\/p>\n

Modes of Transmission<\/h3>\n
\n\n\n\n\n\n\n
<\/td>\nTransmission<\/td>\n<\/tr>\n
Skin Exposure (Needlestick, bite, or scratch):<\/td>\nYes<\/td>\n<\/tr>\n
Mucous Membrane Splash to Eye(s), Nose or Mouth:<\/td>\nYes<\/td>\n<\/tr>\n
Inhalation:<\/td>\nNo<\/td>\n<\/tr>\n
Ingestion:<\/td>\nYes<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n

<\/strong>Host<\/strong> Range\/Reservoir
\n<\/strong>Host Range \u2013 Humans, pets and livestock<\/p>\n

Reservoir \u2013 Gastrointestinal tract of humans and animals including mammals, birds, insects, and reptiles<\/p>\n

Symptoms
\n<\/strong>Symptoms related to VRE are specific to the site of infection and are identical to vancomycin sensitive enterococcus infections. In general, urinary tract infections will present as dysuria, increased frequency of urinary, abdominal discomfort. Skin and soft tissues infections may occur. Systemic disease may present as fever, hypotension, malaise.<\/p>\n

Incubation period
\n<\/strong>As VRE can be a colonizer, disease may not manifest until infection is caused during an opportunistic setting.<\/p>\n

Viability<\/strong>
\nSusceptible to 70% isopropyl alcohol, 70% ethanol, 5.25% sodium hypochlorite, phenolic and quaternary ammonia compounds, and glutaraldehyde. Resistant to 3% hydrogen peroxide<\/p>\n

Survival Outside Host
\n<\/strong>Enterococci can grow and survive in harsh environments, and can persist almost anywhere including soil, plants, water, and food. Enterococcus <\/em>spp can survive 5 days to 4 months on dry inanimate surfaces.<\/p>\n

Information for Lab Workers<\/h2>\n

Laboratory PPE<\/h3>\n

Lab coat, gloves and eye protection but not limited to when direct skin contact with infected materials or working with infected animals.<\/p>\n

Containment<\/h3>\n

BSL-2 facilities, equipment, and operational practices for work involving infectious or potentially infectious materials, animals, or cultures. Procedures that are likely to generate aerosols should be conducted in a biosafety cabinet. Practices may be enhanced based on risk assessment.<\/p>\n

In Case of Exposure\/Disease<\/h3>\n