Mandatory Surveillance of Glycopeptide-Resistant Enterococci (GRE) bacteraemia

The results of the mandatory Glycopeptide-Resistant Enterococci (GRE) bacteraemia enhanced surveillance scheme:

Background information

Reporting of clinically significant GRE bacteraemia has been mandatory for NHS acute trusts in England since September 2003.

This scheme is operated by the Health Protection Agency on behalf of the Department of Health. Data are requested quarterly from each of the 167 acute NHS trusts in England by Health Protection Agency Local and Regional Services Division (LARS) and collated and analysed by the Centre for Infections.

The National Glycopeptide-Resistant Enterococcal Bacteraemia Surveillance Working Group recommended that the significance of blood cultures containing GRE should be assessed clinically. If a bacteraemia is found to be clinically significant and due to either a GRE or a GRE and other non-GRE organism(s), it should be reported as a GRE bacteraemia.

Positive blood cultures from the same patient within 14 days of the initial culture are considered to be part of the original episode and should not be reported. Duplicate reports, more than 14 days apart should be reported as these are considered to be a separate episode.

Enterococci from blood cultures should be tested for susceptibility to the antibiotic vancomycin. Teicoplanin is not an acceptable alternative to vancomycin for these purposes.

Previous publications

Results of the first year of mandatory GRE bacteraemia reporting: October 2003 - September 2004, are published on the Department of Health website and on the HPA website CDR Wkly 2005 15 (34).