School of Public Health and Community Medicine - University of Washington - Aut 2008

Vancomycin-resistant Enterococci (VRE), bacteria rarely seen outside of a health care setting in North America, has been found on Washington and California public marine beaches and in coastal waters.

In October, Professor Marilyn Roberts and Assistant Professor Scott Meschke presented this finding at the “Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America” in Washington, DC. Their study was the first to isolate and identify strains of VRE from an environmental source in North America.

Enterococci live in the gastrointestinal tract of humans and animals and are part of the normal flora. They usually do not cause disease unless they escape from the gut. Enterococci can be spread through fecal contamination, on hands or surfaces, and potentially cause infections in the urinary tract or in open wounds. Vancomycin, an antibiotic, is often used to treat infections caused by Enterococci. The emergence of VRE lies in the bacteria’s insidious ability to acquire new genes that confer resistance to multiple antibiotics.

VRE were first reported in the United Kingdom in 1988, and since 1993, have been identified in wastewater, farm settings, and surrounding communities in multiple European countries and other parts of the world. The isolation of VRE from municipal, hospital, and agricultural wastewater has raised concerns over the possible transmission of VRE to the general public by an environmental and waterborne route.

It’s a “hearty bug,” said Roberts. VRE can survive on floors, on sinks, in water, and even in sand. So, if VRE is in the sand and water at public beaches, then these sources could be possible routes of transmission to beach visitors who may inadvertently carry VRE home on contaminated towels, bags, or clothing.

Roberts and Meschke found strains of VRE in samples taken from four of six Western Washington sites and from one of two California locations, a discovery that suggests other North American beaches could also be reservoirs.

The results presented from the current study are unlikely to be unique, and further studies are needed to determine the current environmental distribution of VRE in North American marine and fresh water beaches. The level of risk to the public for acquiring VRE, when visiting public beaches where VRE can be isolated, is unknown at this time. Thus the public should be aware of the potential of contamination of their food, clothes, and other items when visiting public beaches.

FOR FURTHER READING

Vancomycin-resistant Enterococci (VRE)

Top