VRE stands for vancomycin-resistant enterococci.

Enterococci are bacteria that normally live in the intestines and in the female genital tract, and are also present in soil and water. Most of the time, these germs don’t cause any harm, but if they get into certain places in the body, such as the urinary tract, bloodstream, or a wound, they can cause an infection.

Vancomycin is an antibiotic that is commonly used to treat these infections, but as with a number of other bacteria that have developed antibiotic resistance — the ability of certain germs to fight off the drugs that have been formulated to kill them — enterococci has learned to adapt and prevail against the drug. These hard-to-kill bacteria are called vancomycin-resistant enterococci (VRE).

According to the U.S. National Library of Medicine, VRE infections can be difficult to treat because there are fewer antibiotics that can fight this resistant bacteria. In fact, VRE is listed as one of the key antibiotic-resistant pathogens that pose a threat to human health in the Centers for Disease Control and Prevention’s 2019 Antibiotic Resistance Threats in the United States report. The report classifies 18 antibiotic-resistant germs into three categories — urgent, serious, and concerning. VRE, which was estimated to have caused 54,500 infections among hospitalized patients and led to the deaths of 5,400 people, is listed in the “serious” category.

Causes and Risk Factors of VRE

To understand how antibiotic-resistant bacteria such as VRE emerges, it helps to first understand how bacteria and fungi change in response to medicines designed to kill them. According to the CDC Antibiotic Resistance Threats Report, germs naturally evolve constantly, and can develop new ways to avoid the effects of antibiotics. Once that happens, the resistant germ survives and multiplies, and the surviving germs, which now have resistance traits in their DNA, pass on this genetic information to subsequent generations. These resistant germs can continue to spread and pose an increasing threat to people’s health.

VRE are most commonly found in healthcare settings such as nursing homes or hospitals, particularly in areas where there are people with weakened immune systems such as intensive care units or cancer or transplant wards. VRE can cause infections in patients and then spread to others when the patient is transferred to another facility or goes home.

VRE is typically not spread through the air like a cold or the flu and it cannot be spread through casual contact such as hugging. It is spread by direct contact with an infected person’s bodily fluids, such as blood, phlegm, urine, or stool, or by touching surfaces that have been contaminated by the bacteria.

If you are healthy, your chances of getting sick from VRE are very low, even if you have been exposed to the bacteria. But if you have a weakened immune system, that can be a very different story.

People who are more likely to have VRE include:

  • Those who have been treated with antibiotics, including vancomycin (particularly for long periods of time)
  • Individuals who have been hospitalized (particularly if you had surgery or have had medical devices such as catheters inserted into your body)
  • People who have weakened immune systems, such as those who have a long-term illness or are in intensive care units or cancer or transplant wards of a hospital

Duration of VRE

How long you have a VRE infection can depend on how serious it is and how well it responds to treatment.

In some people, the VRE infection can go away on its own as their bodies naturally become stronger. This process can take a few months or even longer.

Complications of VRE

While VRE can remain harmless in the body, it can also multiply and wreak havoc. The bacteria can invade the bloodstream and cause a wide variety of illnesses, including the following:
  • Bacteremia (bacterial infection that has spread to the bloodstream)
  • Urinary tract infection
  • Endocarditis (infection of a heart valve)
  • Meningitis
  • Wound infection
  • Pneumonia
  • Intra-abdominal infections (such as peritonitis)
  • Pelvic infections
  • Skin and soft tissue infections

Related Conditions of VRE

Conditions that may resemble those caused by VRE infection (but may not necessarily be caused by this bacteria) include:
  • Bacterial sepsis
  • Other hospital-acquired infections
  • Endocarditis
  • Peritonitis and abdominal sepsis
  • Septic arthritis
  • UTI
  • Wound infection

Resources We Love

Centers for Disease Control and Prevention (CDC)

The CDC is leading the charge against antibiotic-resistant pathogens such as VRE. This page details important information about what VRE is and how we can protect ourselves from this and other antibiotic-resistant germs that threaten our health. It also links to the 2019 Antibiotic Resistance Threats Report, which lays out useful and important information about VRE and other dangerous bacteria that should be on everyone’s radar.


This site from the U.S. National Library of Medicine offers essential information about who is at risk for VRE and how to prevent the spread of this potentially dangerous, even deadly bacteria.

Michigan Medicine

University of Michigan’s Michigan Medicine explains in simple, jargon-free language exactly why VRE is a problem; what we need to know about basics such as how it’s spread, diagnosed, and treated; and, most importantly, how to prevent it.

Additional reporting by Joseph Bennington-Castro.

Editorial Sources and Fact-Checking

  • Vancomycin-Resistant Enterococci — Hospital. MedlinePlus. January 25, 2021.
  • Antibiotic Resistance Threats in the United States, 2019. Centers for Disease Control and Prevention. December 2019.
  • Levitus M, Rewane A, et al. Vancomycin-Resistant Enterococci. StatPearls. July 21, 2020.
  • Bacteremia. Merck Manual. February 2020.
  • Urinary Tract Infection (UTI). Mayo Clinic. October 14, 2020.
  • Vancomycin-Resistant Enterococci (VRE) in Healthcare Settings. Centers for Disease Control and Prevention. November 13, 2019.
  • Vancomycin-Resistant Enterococci (VRE). Michigan Medicine. January 25, 2020.


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