Enterococci are gram-positive bacteria that are part of the normal bowel flora of humans and the female genital tract but can cause severe infections when they gain access to other parts of the body. Vancomycin is the antibiotic that usually works to treat these infections. These resistant strains are referred to as VRE (Vancomycin-Resistant Enterococcus faecalis). Vancomycin resistance is of particular concern because of treatment difficulties, and because of the potential to be transferred to other microorganisms. Populations at increased risk for VRE infection or colonization include critically ill patients, or those with severe underlying disease or immunosuppression such as ICU, transplant, and oncology patients, patients undergoing intra-abdominal or thoracic surgery, or with indwelling urinary or central venous catheters, and those having prolonged hospitalizations. VRE can spread from person-to-person by direct patient-to-patient contact or indirectly on health care workers hands, or on contaminated environmental surfaces and patient care equipment.