Glycopeptide Resistant Enterococci

Introduction

Enterococci are part of the normal flora of the bowel in humans. The most important species are Enterococcus faecalis and Enterococcus faecium. Common infections caused by enterococci are urinary tract infection and intra-abdominal infections. Although less common, they can cause serious infections such as bacteraemia and infective endocarditis in patients with risk factors. There have been outbreaks of enterococcal bacteraemia described in haematology units, ITUs and liver units.

Glycopeptide resistant enterococci (GRE) are resistant to vancomycin, teicoplanin and often other antibiotics. Infection caused by these organisms is rare, but when they cause serious infection they pose a therapeutic challenge. Patients who are susceptible to acquiring GRE include those previously on antibiotics, immunosuppressed patients and those previously hospitalised. Some patient groups are more commonly colonised, but without ill effects. Once gut colonisation has occurred, carriage can be prolonged and there is no effective means of eradication.

Appropriate use of antibiotics, following the Trust’s Antibiotic Guidelines, will reduce the selection pressure for colonisation and infection with GRE.

Purpose

These guidelines aim to ensure that patients colonised or infected with GRE receive effective and appropriate care to minimise the transmission of GRE.

Policy Details

See also:

• Hand Hygiene Policy for Healthcare Workers
• Standard Precautions Policy
• Glove Policy