B. The potential exists for VRE to transfer genetic vancomycin resistance to other gram-positive organisms, including Staphylococcus aureus. This transfer has not yet occurred clinically. All health care institutions must become aware of the threat and involved in the control of these pathogens. Enterococci can also be found without causing infection along catheter sites and in the urine.
Many enterococcal infections are mixed infections in which the role of enterococci is uncertain.
All enterococci have intrinsic low-level resistance to some antibiotics. In recent years, however, some strains of enterococci have acquired high-level resistance to multiple antibiotics including aminoglycosides, ampicillin, and vancomycin. Virtually all VRE are E. faecium. A dramatic increase in the incidence of VRE has been seen in the past few years. Most enterococcal infections probably arise from bacteria in the patient's own gastrointestinal tract.