Vancomycinresistant Entercocci as a Possible BioTerrorist Weapon and Health Care Defense Tactics

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Entercocci are gram-positive bacteria and all Entercocci have intrinsic resistance to antibiotics. This resistance has increased since 1988 when it was first seen as a public health risk in Europe. Vancomycin Resistance Entercocci (VRE) was first identified in the United States in 1993. From 1993 the proportion of entercoccal isolates resistant to vanomycin reported to the National Nosocomical Infections Surveillance System increased 20-fold. (McDonald n.d. para 1) Enterococci is found the gastrointestinal and female genital tracts and identified in lab reports as Enterococci faecium, Entercocci faecallis or Entercocci species. This bacteria is found along catheter sites and in urine without causing infection. (Community Health Administration guidelines 1996, Background) The infection usually occurs after an introduction of the bacteria into a preciously sterile environment. A procedure such as in-dwelling catheters, cardiothoracic surgery, transplants, and extended stays in ICU wards increases the risk of acquiring VRE. One method of transfer was discovered in the use of a suction device that removes oral and nasal secretions common in the ICU and Yankauer Catheters. (Kayyali 2006 para 1)VRE also spreads easily by computer keyboards with or without covers. Since most health care documentation is done electronically, this is a serious concern in all areas of the hospital, but in particular, critical care units. Long Term Care facility (LTC) patients are also at risk. VRE and Methacillin Resistant Staphyloccos Aureus (MRSA) have been shown to survive on keyboards for an hour and on covers for five minutes. Bare hands transferred the bacteria at a considerably higher percentage than gloved hands. (Computer Bugs, 2005 pg 1)