Vancomycin-resistant enterococci (VRE) infection or colonisation

Statutory notification

• Vancomycin-resistant enterococci (VRE) colonisation or infection is notifiable in Western Australia.
• See notifiable disease case definitions (Word 1.29MB).
• Private and public laboratories that identify VRE cases are required to notify patient details to the Microbiology Department, PathWest Laboratory Medicine Western Australia (LMWA) Gram-positive Typing Laboratory* at Fiona Stanley Hospital.
• See also description of statutory medical notifications in Western Australia.

Public health management

Important information

• Infectious agent: enterococci are part of the normal flora of the gastrointestinal tract and are inherently resistant to most antibiotics. Although not highly pathogenic, VRE can cause serious infection in immunocompromised patients. There are several different enterococci but those of importance in the context of vancomycin resistance are Enterococcus faecium and Enterococcus faecalis.
• Transmission: Person-to-person through direct contact with an infected or colonised person or the contaminated hands of a healthcare worker, or indirectly from contact with contaminated environmental surfaces or medical equipment. Enterococci are capable of prolonged survival on environmental surfaces for several months.
• Incubation period: Variable.
• Infectious period: As long as VRE is shed from the colonised or infected person.
• Case exclusion: Do not exclude. Healthcare facility patients colonised or infected with a VRE should be managed in a single room with dedicated bathroom facilities as per the Guidelines for the Screening and Management of Multi-resistant Organisms in Healthcare Facilities.
• Contact exclusion: Do not exclude.
• Treatment: Antibiotic treatment for clinical infections as recommended by the doctor.
• Immunisation: None available.
• Case follow-up: Is conducted by hospitals, and the Communicable Disease Control Directorate, as required.

Information for GPs and other healthcare providers 

• Vancomycin-resistant enterococci – information for consumers (Healthy WA)

Management in healthcare facilities

• Guidelines for the Screening and Management of Multi-resistant Organisms in Healthcare Facilities

Notifiable disease data and reports

VRE infection or colonisation is a notifiable condition via laboratory notification in WA.

*The Gram-positive Typing Laboratory PathWest LMWA works in collaboration with the Antimicrobial Resistance Infectious Diseases Research (AMR-ID) Laboratory, Murdoch University to undertake further molecular typing and characterisation of isolates. VRE surveillance data are therefore reported separately to other notifiable disease data.