Vancomycin-resistant enterococcus: a review from a Singapore perspective.
BACKGROUND
Vancomycin-resistant enterococcus (VRE) can cause serious infections in vulnerable, immunocompromised patients.


METHODS
In this article, we summarise current data on epidemiology, detection, treatment and prevention of VRE.


RESULTS
VRE was first isolated in Singapore in 1994 and until 2004 was only sporadically encountered in our public hospitals. After 2 outbreaks in 2004 and in 2005, VRE has become established in our healthcare institutions. Multiple studies have shown that VRE spreads mainly via contaminated hands, cloths and portable equipment carried by healthcare workers.


CONCLUSIONS
Only a comprehensive programme (consisting of active surveillance, isolation of colonised/infected patients, strict adherence to proper infection control practices and anti-microbial stewardship) can limit the spread of these organisms. In addition to monitoring the compliance with traditional infection control measures, new strategies that merit consideration include pre-emptive isolation of patients in high-risk units and molecular techniques for the detection of VRE.
Chlebicki
Maciej Piotr
MP
Department of Internal Medicine, Singapore General Hospital, Singapore. pchlebicki@hotmail.com
Kurup
Asok
A
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D012846:Singapore; D014640:Vancomycin / Q000494:pharmacology* / Q000627:therapeutic use; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents; D014640:Vancomycin