Nosocomial infections in pediatric patients: a prevalence study in Spanish hospitals. EPINE Working Group.
BACKGROUND
The magnitude of the problem of nosocomial infection in children has never been studied in Spain.


METHODS
In 1990, a nationwide cross-sectional study was conducted to determine the prevalence of nosocomial infection and associated risk factors.


RESULTS
Among 38,489 patients surveyed, 4081 were pediatric patients. Three hundred forty-five patients (8.4%) had active nosocomial infection at the time of the survey. Pediatric intensive care units (29.7%), hematology (23%), and special units (22%) showed the highest rates. Infections were most common in patients younger than 1 year (prevalence, 12.3%). Frequencies of nosocomial infection by site were as follows: bloodstream, 22.1%; urinary tract, 13.1%; lower respiratory tract, 12.3%; postoperative wound, 8%; gastrointestinal tract, 7.6%; skin, 6.5%; eye, 5.8%; and others 24.6%. The factors most closely associated with a higher prevalence of nosocomial infection in pediatrics were as follows: age younger than 1 year, surgery, moderate and severe baseline risk, number of diagnoses, and all categories of extrinsic risk factors. The most frequent etiologic agents were gram-positive bacteria (45.8%).


CONCLUSIONS
Although the overall prevalence is at an acceptable level, future efforts should be focused on developing more effective prevention strategies in specific areas.
Servei de Medicina Preventiva, Vall d'Hebron Hospital, Universitat Autónoma de Barcelona, Spain.
M
M
Campins
J
J
Vaqué
J
J
Rosselló
S
S
Salcedo
M
M
Durán
V
V
Monge
J
J
García Caballero
M C
MC
Sáenz
F
F
Calbo
L
L
Armadans
D000293:Adolescent; D016470:Bacteremia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000145:classification / Q000453:epidemiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009181:Mycoses / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology; D014777:Virus Diseases / Q000453:epidemiology / Q000382:microbiology