A surreal depiction of a battle against antibiotic resistance within the human body.

VRE in Saudi Arabia: What You Need to Know About This Emerging Threat

Soraya Malik in Health & Wellness August 2025 • 4 min read.

"A comprehensive overview of the prevalence, characteristics, and risk factors of vancomycin-resistant enterococci (VRE) in Saudi Arabia, and what it means for you."

Vancomycin-resistant enterococci (VRE) are Gram-positive bacteria resistant to vancomycin, a powerful antibiotic. Infections caused by VRE lead to longer hospital stays, higher medical costs, and increased mortality rates. Understanding VRE, especially its prevalence and characteristics, is crucial for protecting your health and the health of your community.

In Saudi Arabia, clinical and surveillance reports have highlighted the presence of VRE isolates. This article provides a comprehensive look at the prevalence, characteristics, risk factors, resistance mechanisms, and virulence of VRE isolates associated with infections and colonization in Saudi Arabia.

Whether you're a healthcare professional, someone with underlying health conditions, or simply health-conscious, this information is vital for understanding and mitigating the risks associated with VRE.

Understanding the Scope of VRE in Saudi Arabia: Prevalence, Risk Factors, and Resistance

A surreal depiction of a battle against antibiotic resistance within the human body.

VRE was first detected in Saudi Arabia in 1992, and since then, numerous reports have documented its presence. The prevalence rate of VRE infection in Saudi Arabia ranges from 1% to 17.3%. Recent data indicates that hospital-acquired VRE infections are on the rise, signaling an accelerating threat. While the prevalence rate is comparable to some countries like Canada, China, Finland, and Italy, it remains lower than in Portugal, Greece, Ireland, and North America.

Between 1992 and 2015, 218 VRE isolates were identified in Saudi Arabia, with Enterococcus faecium being the most common (156 isolates), followed by E. faecalis (8 isolates) and E. gallinarum (12 isolates). The majority of isolates were recovered from patients admitted to intensive care units (ICUs). Key isolation sites included blood, stool, rectal swabs, and wounds.

ICU admissions
Oncology unit stays
Underlying chronic diseases
Malignancies
Chemotherapy and steroid therapy
Prior antibiotic use
Central line insertions

The presence of van genes determines vancomycin resistance in Enterococcus species. VanA and VanB genes are the most prevalent worldwide. These genes modify the bacterial cell wall, reducing vancomycin's binding affinity. While VanA confers high-level resistance to vancomycin and teicoplanin, VanB exhibits a broader range of vancomycin resistance. The horizontal transfer of these genes contributes to the spread of resistance within and between species.

The Future of VRE in Saudi Arabia: What Can Be Done?

VRE infections in Saudi Arabia present a significant healthcare challenge due to their association with high mortality rates. The prevalence of VRE varies across different reports, but the overall trend indicates an increasing threat. This underscores the need for robust infection control measures and antibiotic stewardship programs.

Further research is needed to fully understand the economic burden of VRE infections in Saudi Arabia. Enhanced surveillance, diagnostic capabilities, and adherence to infection control protocols are essential to curb the spread of VRE. These steps will help reduce the impact of VRE on patient outcomes and healthcare costs.

By understanding the risks, embracing preventive measures, and supporting ongoing research, we can collectively work towards mitigating the impact of VRE in Saudi Arabia and beyond.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1089/mdr.2018.0241, Alternate LINK

Title: Overview Of Prevalence, Characteristics, Risk Factors, Resistance, And Virulence Of Vancomycin-Resistant Enterococci In Saudi Arabia

Subject: Microbiology (medical)

Journal: Microbial Drug Resistance

Publisher: Mary Ann Liebert Inc

Authors: Mohammad Abdallah, Mohammad Al-Saafin

Published: 2019-04-01

Everything You Need To Know

What exactly are Vancomycin-Resistant Enterococci (VRE), and why are they a cause for concern?

Vancomycin-resistant enterococci, or VRE, are Gram-positive bacteria that have developed resistance to vancomycin, a powerful antibiotic often used as a last resort. This resistance makes VRE infections difficult to treat, leading to longer hospital stays, increased medical costs, and higher mortality rates. The rise of VRE is a serious concern because it limits the treatment options available for enterococcal infections.

How widespread is VRE in Saudi Arabia, and what do current trends indicate about its prevalence?

In Saudi Arabia, VRE was first detected in 1992, and its prevalence has been documented in numerous reports since then. The prevalence rate ranges from 1% to 17.3%. Recent data indicates a concerning trend: hospital-acquired VRE infections are on the rise, which means VRE poses an increasing threat to public health within Saudi Arabia.

What are the primary risk factors that make individuals more susceptible to VRE infections?

Several factors increase the risk of VRE infection, including ICU admissions, oncology unit stays, underlying chronic diseases, malignancies, chemotherapy and steroid therapy, prior antibiotic use, and central line insertions. These conditions and treatments often weaken the immune system or disrupt the normal balance of bacteria in the body, making individuals more susceptible to VRE colonization and infection.

How do bacteria develop resistance to vancomycin, and what role do specific genes play in this process?

Vancomycin resistance in Enterococcus species is primarily determined by the presence of van genes, with VanA and VanB being the most prevalent. These genes modify the bacterial cell wall, reducing vancomycin's ability to bind effectively. VanA confers high-level resistance to both vancomycin and teicoplanin, while VanB exhibits a broader range of vancomycin resistance. The horizontal transfer of these genes allows resistance to spread within and between bacterial species, exacerbating the problem.

What strategies can be implemented to combat the increasing threat of VRE infections in Saudi Arabia?

Addressing VRE infections in Saudi Arabia requires a multi-faceted approach, including robust infection control measures and comprehensive antibiotic stewardship programs. Hospitals and healthcare facilities must implement rigorous hygiene protocols to prevent the spread of VRE. Prudent antibiotic use is essential to reduce the selective pressure that drives the development of antibiotic resistance. Further research into novel treatment strategies and preventive measures is also needed to combat the growing threat of VRE.