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-RESISTANT ENTEROCOCCI (VRE) THREAT LEVEL SERIOUS

54,500 5,400 $539M Estimated cases Estimated Estimated attributable in hospitalized deaths in 2017 healthcare costs in 2017 patients in 2017

Enterococci, a type of , can cause serious for patients in healthcare settings, including bloodstream, surgical site, and urinary tract infections.

WHAT YOU NEED TO KNOW CASES OVER TIME ■■ About 30% of all healthcare-associated enterococcal Continued control and appropriate antibiotic use are infections are resistant to vancomycin, reducing important to maintain decreases in VRE infections. treatment options. 100,000 ■■ Nearly all VRE infections happen in patients with healthcare exposures. Risk factors for VRE infection 84,800 include stays in long-term care hospitals or intensive 80,000 73,800 66,400 care units (ICUs), undergoing organ transplant, or 63,700 61,100 receiving treatment for certain types of cancer. 60,000 54,500 ■■ VRE is increasingly resistant to additional antibiotics, raising concern that the remaining drugs to treat VRE 40,000 may become less effective.

20,000 Estimated Cases of VRE in Hospitalized Patients Estimated 0 2012 2013 2014 2015 2016 2017

60,000

50,000

40,000

30,000

20,000 Estimated Cases of VRE Estimated

10,000

0 2012 2013 2014 2015 2016 2017

Hospital-onset infections Community-onset infections 100,000

84,800

80,000 73,800 66,400 63,700 61,100 60,000 54,500

40,000

ed Cases of VRE in Hospitalized Patients 20,000 t tim a E s 0 VANCOMYCIN-RESISTANT ENTEROCOCCI (VRE) 2012 2013 2014 2015 2016 2017

PATIENTS AT RISK COMMUNITY AND HOSPITAL CASES Patients at high risk for VRE infections include There were significant decreases in hospital- and those who are undergoing complex or prolonged community-onset VRE cases—around 30,400 fewer cases healthcare (such as patients in long-term acute in 2017 compared to 2012. care hospitals or ICUs) or patients with weakened immune systems (such as patients undergoing 60,000 cancer treatment or with organ transplants).

In solid organ transplant units, one type of 50,000 VRE— faecium (E. faecium)—is the most common cause of central line-associated 40,000 (CLABSIs), according to CDC’s National Healthcare Safety Network. 30,000 ed Cases of VRE More than 70% of these E. faecium are resistant t to vancomycin, a mainstay for treating these tim a 20,000 E s infections. This makes healthcare providers reliant on other antibiotics. 10,000

Maintaining and improving infection prevention and 0 control interventions, such as hand hygiene and 2012 2013 2014 2015 2016 2017 surface disinfection, is critical to further reduce the Hospital-onset infections Community-onset infections number of VRE infections and protect vulnerable patient populations. Community-onset infections include infections in patients with recent healthcare exposure and infections in people without prior healthcare exposure.

ONLINE RESOURCES

About VRE in Healthcare Settings www.cdc.gov/hai/organisms/vre/vre.html

This fact sheet is part of CDC’s 2019 Antibiotic Resistance Threats Report. The full report, including data sources, is available at www.cdc.gov/DrugResistance/Biggest-Threats.html. CS298822-A