Prevalence of hospital-acquired infections in Spain. EPINE Working Group.

In May 1990 a prevalence survey of hospital-acquired infections was conducted in 123 Spanish hospitals, in which 38,489 patients were studied. There was an 8.5% prevalence of infected patients and a 9.9% prevalence of infections. The most common infections were those of the urinary tract (27.7%), surgical wound (22.7%) and lower respiratory tract (15.4%) and bacteraemia (10.6%). There was a 5.9% prevalence of patients with surgical wound infection and 3.5% after clean surgery. An aetiological diagnosis was made in 58% of the infections. Gram-negative bacteria were dominant, Escherichia coli (16.3%) and Pseudomonas aeruginosa (11.5%) being the most prevalent; 33.8% of the patients were receiving antimicrobial agents. The following procedures were shown to be significantly associated with hospital-acquired infections: urinary catheterization, parenteral nutrition, mechanical ventilation and tracheostomy. The degree of contamination during surgery was also a significantly associated risk factor. The survey provided extensive information on the distribution of infections and the use of antibiotics in clinical services, as well as the differences between hospitals according to their size and the presence of certain risk factors.