Definition

Vancomycin is an antibioticand enterococci are common intestinal bacteria. These do not normally cause disease. After using antibiotics especially cephalosporins for infections, enterococci can become resistant so that the treatment no longer works. Vancomycin is effective against many life-threatening infections, but some enterococci have become resistant. Vankomycin-resistant enterococci are also called VRE.

People with impaired immune system, thus also patients undergoing immunosuppression antirheumatic drugs can be seriously ill by VRE.

Screeing

All persons who have been admitted to health institutions / hospitals outside the Nordic region during the past 12 months

• All who have been admitted to a Norwegian or Nordic hospital with ongoing VRE outbreaks. In 2018 it was relevant for Haukeland Hospital in Bergen and Hospital in Drammen)
• If one case is detected, all patients in the same department should be examined
• The staff takes precautions but need not be examined
• ESBL and multi-resistant bacteria; please read on separate page here (in Danish)
• More information here (Norwegian Institute of Public Health)

Diagnosis

• Growth of VRE from rectal brush
• Resistance genes are detected at PCR
• More information here (in Danish) (NIPH)

Message

• Microbiological laboratory and attending physician reports VRE to MSIS at the Norwegian Institute of Public Health
• The doctor also reports to the patient's local authority
• More information here (in Danish) (NIPH)

Handling

• The patient is isolated
• Infection control routines are carried out
• Information is provided when transferring
• More information here (in Danish) (NIPH)

Literature

• Public Health Institute (2018)
• Wikipedia

• ESBL and multiresistant bacteria
• Bindevevssykdommer.no
• Vaskulitt.no