Vancomycin-Resistant Enterococci (VRE) are a type of bacteria that commonly reside in the human intestines and female genital tract. While often harmless, some strains have developed resistance to vancomycin, an antibiotic frequently used to treat bacterial infections. Understanding VRE persistence on surfaces is important for limiting its presence in public spaces and healthcare environments. This knowledge helps in developing effective strategies to prevent its spread.
VRE Survival on Surfaces
VRE can persist on dry, inanimate surfaces for varying lengths of time, from a few days to several months. Research indicates that VRE can survive for 5 days to 2 months, with some studies documenting viability up to 4 months. In some instances, VRE has remained viable for over three years, particularly on glass surfaces.
The duration of VRE survival on surfaces is influenced by several factors. The type of surface plays a role, with VRE surviving well on hard, non-porous materials such as plastics, metals, and glass. These bacteria are found on objects like toilet seats, door handles, bedrails, furniture, and medical equipment. Dry environmental conditions also support prolonged VRE survival.
The initial amount of bacteria present on a surface, known as the bacterial load, also affects how long VRE can survive. Higher concentrations can lead to extended survival times, as nutrients from dying bacterial cells may help sustain the remaining population. This persistence contributes to environmental contamination and the spread of VRE.
How VRE Spreads from Surfaces
VRE primarily spreads through indirect contact, rather than through the air by coughing or sneezing. This occurs when individuals touch contaminated surfaces and then transfer the bacteria to themselves, such as by touching their eyes, nose, or mouth. The bacteria can also be transferred to other people or surfaces through subsequent contact.
Hands serve as a common vehicle for the transfer of VRE. Healthcare settings are susceptible to VRE spread due to frequent contact between patients, healthcare workers, and shared equipment. Inanimate surfaces within these environments act as reservoirs for the bacteria.
Healthcare workers’ hands can become contaminated after touching VRE-positive patients or their immediate environment. If proper hand hygiene is not performed, these contaminated hands can transfer the bacteria to other patients or surfaces, facilitating transmission.
Preventing VRE Transmission
Preventing VRE transmission relies heavily on diligent environmental cleaning and effective hand hygiene practices. Thorough and frequent cleaning and disinfection of high-touch surfaces are important, especially in healthcare settings. Surfaces such as bed rails, doorknobs, and medical equipment should be regularly cleaned using appropriate disinfectants.
Hospital-grade disinfectants, bleach solutions, or combined detergent/disinfectant products are effective against VRE. Cleaning materials should be changed after use in each room to prevent cross-contamination.
Hand hygiene remains the most impactful measure in preventing VRE spread. This involves washing hands thoroughly with soap and water or using an alcohol-based hand rub. Hands should be cleaned before and after patient contact, after using the bathroom, and before preparing food.
In healthcare environments, the proper use of personal protective equipment (PPE) like gloves and gowns is also a component of infection control. These barriers should be worn when contact with bodily fluids or contaminated surfaces is expected. Removing PPE and performing hand hygiene immediately before leaving a patient’s room minimizes the risk of spreading VRE.