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The VRE (Vancomycin-resistant enterococci) rate is calculated as a rate per 1,000 patient days.

The “total patient days” represents the sum of the number of days during which services were provided to all inpatients during the given time period.

The rate is calculated as follows:
Number of new hospital acquired cases of VRE in Baycrest Hospital divided by Total number of patient days (for one month) x 1000.

For information about Baycrest's rates, please visit the Health Quality Ontario website.

    What is Vancomycin-resistant enterococci (VRE)?

    Enterococci are germs that live in the gastrointestinal tract (bowels) of most individuals and generally do not cause harm (this is termed “colonization”). Vancomycin-resistant enterococci (VRE) are strains of enterococci that are resistant to the antibiotic vancomycin. If a person has an infection caused by VRE, such as a urinary tract infection or blood infection, it may be more difficult to treat.

    How is VRE spread?

    VRE is spread from one person to another by contact, usually on the hands of caregivers. VRE can be present on the caregiver’s hands either from touching contaminated material excreted by an infected person or from touching articles soiled by faeces. VRE can survive well on hands and can survive for weeks on inanimate objects such as toilet seats, taps, door handles, bedrails, furniture and bedpans. VRE is easy to kill with the proper use of disinfectants and good hand hygiene.

    What is bacteraemia?

    Bacteraemia is the presence of bacteria in the bloodstream and is referred to as a bloodstream infection.

    What is a case of VRE bacteraemia?

    A case is a patient identified with laboratory confirmed bloodstream infection with Vancomycin-resistant Enterococcus (VRE-Bacteraemia). A blood stream infection is a single positive blood culture for VRE.

    What are the risk factors for VRE?

    Risk factors for VRE include severity of underlying illness, presence of invasive devices, prior colonization with VRE, antibiotic use and length of hospital stay.

    What special precautions are required for VRE?

    It is important that special precautions are taken to stop VRE from spreading to other patients in the hospital. These precautions include:

    • Single room accommodation (the door can remain open)
    • A long-sleeved gown and gloves must be worn by everyone who cares for you
    • A sign may be placed on your door to remind others who enter your room about the special precautions
    • The room and the equipment used in the room will be cleaned and disinfected regularly
    • Everyone who leaves your room must clean their hands well
    • You must wash your hands before you leave your room

    What about Family/Visitors?

    Your family and visitors should not assist other patients with their personal care as this may cause the germ to spread. They may be required to wear a long-sleeved gown and gloves while in your room. Before leaving your room, visitors must remove the gloves and gown and dispose of them in the garbage container and the linen hamper located in your room. Then they must clean their hands.

    Good Hand Hygiene Practices

    Remind all staff and visitors to practice good hand hygiene before and after they touch you (patient). Ask your nurse or doctor to demonstrate proper hand hygiene techniques (15 seconds of soap and running water OR waterless alcohol hand rub until hands are dry). You need to clean your hands:

    • After using the bathroom
    • After blowing your nose
    • Before eating and drinking
    • Before and after you touch your dressing or wounds
    • When your hands are visibly dirty (soiled)
    • Before you leave your room
  • Public Reporting and Rates

    What will be publicly reported?

    Each hospital will post its quarterly rate and case count of new VRE bacteraemia acquired in their facility. At the end of each quarter, the ministry will report the previous quarter’s data on its website by hospital site including:

    • the number of new hospital acquired VRE bacteraemia cases that is zero (0) or totalling five (5) or more associated with that hospital site, or if this is less than 5 cases (i.e. 1 to 4 cases), text reading “the hospital acquired VRE bacteraemia rate

    It is important to note that VRE bacteraemia rates do not necessarily reflect the rate of VRE colonization in the hospital.

    For information about Baycrest's rates, please visit the Health Quality Ontario website.

    What determines the rate?

    The total number of new cases of VRE bacteraemia acquired in the hospital in a quarter is divided by the total number of patient days for that quarter. Patient days are the number of days spent in a hospital for all patients.

    The results are multiplied by 1000. This represents the rate of hospital acquired associated VRE bacteraemia associated with the reporting facility per 1000 patient days for that quarter. (e.g. 2 cases for that quarter ÷ 30,000 patient days for that quarter = 0.00006 x 1000 = 0.06 per 1000 patient days). The rates of infection will be calculated by quarter.

    What will the healthcare system do with the rate information?

    Hospital acquired infection rates provide one measure of patient safety and quality of care. The rate of hospital acquired VRE bacteraemia can be used to analyze any trends of infection, sources of infection and general surveillance of VRE bacteraemia. It can also assist hospitals to evaluate the effectiveness of infection prevention and control interventions and make further improvements based on this information.

  • Baycrest Specific Information

    How frequently will Baycrest report on VRE bacteraemia?

    The rates of infection will be calculated by quarter.