Nosocomial Infections in Spain: Results of Five Nationwide Serial Prevalence Surveys (EPINE Project, 1990–1994)

Abstract

Objective: To determine trends in rates of nosocomial infections in Spanish hospitals.Design: Prospective prevalence studies, performed yearly from 1990 through 1994.Setting: A convenience sample of acute-care Spanish hospitals.Participants and Patients: The number of hospitals and patients included were as follows: 1990, 125 hospitals and 38,489 patients; 1991, 136 and 42,185; 1992, 163 and 44,343; 1993, 171 and 46,983; 1994, 186 and 49,689. A core sample of 74 hospitals, which participated in all five surveys and included a mean of 23,871 patients per year, was analyzed separately.Results: The overall prevalence rate of patients with nosocomial infections in the five studies was as follows: 1990, 8.5%; 1991, 7.8%; 1992, 7.3%; 1993, 7.1%; and 1994, 7.2%. The prevalence rate of patients with nosocomial infection in the core sample of 74 hospitals was 8.9%, 8.0%, 7.4%, 7.6%, and 7.6%, respectively (test for trend, P=.0001). Patients admitted to intensive care units had a 22.8% prevalence rate of nosocomial infection in 1994. The most common nosocomial infections by primary site were urinary tract infection and surgical site infections, followed by respiratory tract infections and bacteremia. More than 60% of all infections were supported by a microbiological diagnosis.Conclusions: The EPINE project provides a uniform tool for performing limited surveillance of nosocomial infections in most Spanish acute-care hospitals. Its use helps to spread an accepted set of definitions and methods for nosocomial infection control in the Spanish healthcare system. The surveys indicate that the prevalence of nosocomial infections has been reduced over the last 5 years in a core sample of Spanish hospitals.

A European perspective on nosocomial urinary tract infections II. Report on incidence, clinical characteristics and outcome (ESGINI–04 study)

“…European information regarding this topic is generally fragmentary, covering different populations and areas and difficult to compare with our data [8,9]. The most recently reported prevalence figures that cover a more general population range from 0.5 per 1000 to 24 per 1000, with most around 20 per 1000 [10–15].…”

Surgical site infection – a European perspective of incidence and economic burden

“…Vaqué et al . (50) comment that the trend to earlier discharge and subsequent decrease in hospital stay leads to an increasing number of SSIs being detected in the community and that therefore ‘these infections cannot be detected in prevalence studies’. Studies have revealed that between 12% and 84% of SSIs are detected after discharge from hospital (5,21,51–54).…”

“…Most, but not all, of the incidence studies revealed a defined period of observation (Table 3). Vaqué et al (50) comment that the trend to earlier discharge and subsequent decrease in hospital stay leads to an increasing number of SSIs being detected in the community and that therefore 'these infections cannot . Table 3 presents a useful understanding the relative proportions of SSI versus other types of infections .…”

Intensive care unit acquired infection: a prevalence and impact on morbidity and mortality

“…I nfections in the intensive care unit (ICU) have been under intense study over the past two decades. Critically ill patients are at high risk for the development of hospital‐acquired or nosocomial infection (NI), as evidenced by national and international studies (1–6). Severe infection is a common reason for intensive therapy and contributes to prolonged ICU care, increased morbidity, mortality and financial costs (7–9).…”

“…The prevention of infection in the ICU demands the knowledge of infection rates, source of infection, type, nature of infection and invading microorganisms. The prevalence survey of infection in various countries were published recently (1, 2, 4, 6). However, there are only limited data available on the prevalence of infection in the ICUs in Lithuania.…”