Vancomycin-resistant enterococcus: a review from a Singapore perspective.

INTRODUCTION Vancomycin-resistant enterococcus (VRE) can cause serious infections in vulnerable, immunocompromised patients. MATERIALS AND 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.