[Table of Contents]

Canada Communicable Disease Report - Supplement
Volume: 23S8
December 1997

INFECTION CONTROL GUIDELINES

Preventing the Spread of Vancomycin-Resistant Enterococci (VRE) in Canada

VRE Guidelines Overview

The growing threat of VRE in the United States prompted the development of specific recommendations to prevent the spread of VRE, which were published in early 1995⁽⁶⁷⁾. The recommendations were developed by a subcommittee of the CDC's Hospital Infection Control Practices Advisory Committee (HICPAC). The recommendations focused on a plan that addressed the following issues:

1. Vancomycin use

2. Educational programs

3. Enhancing the detection and reporting of VRE

4. Infection control precautions to prevent nosocomial transmission of VRE.

It is considered prudent to adopt, in principle, the HICPAC recommendations for preventing the spread of VRE for the following reasons: the appearance of VRE in several Canadian institutions in 1995 and 1996; the rising usage of vancomycin and other broad spectrum antimicrobial agents; increased awareness of settings in which some or all of the risk factors for VRE infection and colonization are present; and the current restructuring in Canadian health care facilities. The Canadian Hospital Epidemiology Committee believes that, although the epidemiology of VRE has not been fully elucidated in Canada and that further research is required, it is prudent to take the opportunity to reduce the emergence and spread of VRE in Canada now rather than after VRE has become firmly established. The following guidelines, adapted from the HICPAC recommendations⁽⁶⁷⁾, should be regarded as interim guidelines for Canadian health care facilities and will be subject to modification in the future. The Steering Committee on Infection Control Guidelines will address VRE and other antibiotic-resistant organisms in the Isolation and Precaution Techniques document that is currently being revised.

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