Vancomycin-resistant Enterococcus (VRE)
VRE precautions
- How long
- No fixed duration in CDC’s table — set by facility policy
- Room
- Single room preferred; cohort with patients who have the same MDRO
- PPE
- Gown and gloves on room entry
- Colonized patients
- Included — CDC’s MDRO row covers infection or colonization
- Equipment
- Dedicated or disposable noncritical equipment
Good to know
- CDC’s table lists Enterococcus species under multidrug-resistant organisms when they are vancomycin-resistant or epidemiologically significant.
- CDC leaves the choice of which MDROs need Contact Precautions to each facility’s infection prevention program, based on local, state, regional or national recommendations. CDC recommends them in settings with ongoing transmission, in acute care settings with an increased risk of transmission, and for wounds that cannot be contained by dressings.
- In nursing homes, CDC guidance allows Enhanced Barrier Precautions (gown and gloves during high-contact care activities) for many residents with MDROs instead of full Contact Precautions.
What CDC’s table says
Verbatim from CDC’s Appendix A, with bibliography numbers removed.
Multidrug-resistant organisms (MDROs), infection or colonization (e.g., MRSA, VRE, VISA/VRSA, ESBLs, resistant S. pneumoniae)
ContactStandardMRSA guideDuration—
MDROs judged by the infection control program, based on local, state, regional, or national recommendations, to be of clinical and epidemiologic significance. Contact Precautions recommended in settings with evidence of ongoing transmission, acute care settings with increased risk for transmission or wounds that cannot be contained by dressings. See recommendations for management options in Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006. Contact state health department for guidance regarding new or emerging MDRO.
Test yourself: a CIC-style question
A patient is colonized with VRE but has no signs of infection. How should infection prevention staff view this patient?
- As needing immediate antibiotic treatment
- As a potential source of transmission who may need Contact Precautions
- As irrelevant to infection prevention
- As immune to VRE
Show answer
B. As a potential source of transmission who may need Contact Precautions
Colonized patients carry the organism without clinical infection but can still transmit it. CDC’s MDRO recommendation covers infection or colonization; treating colonization with antibiotics is generally not indicated.
Questions like this come up in the Preventing and Controlling the Transmission of Infectious Agents domain of the CIC® exam. The 654 questions in the app each come with a written explanation.
FAQ
- What precautions are needed for VRE?
- Contact + Standard (when your infection prevention program applies them). Room: Single room preferred; cohort with patients who have the same MDRO. PPE: Gown and gloves on room entry. Colonized patients: Included — CDC’s MDRO row covers infection or colonization. Equipment: Dedicated or disposable noncritical equipment.
- How long do VRE precautions last?
- No fixed duration in CDC’s table — set by facility policy.
Sources
- CDC. Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions (2007 Guideline for Isolation Precautions, updated September 2024)
- CDC. Infection Control Guidance: Candida auris
Checked against CDC on October 21, 2026. For education and CIC® exam preparation only — not a substitute for your facility’s infection prevention policies, your state or local health department, or clinical judgment. CBIC and CDC do not endorse this tool.