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.
Campins
M
M
Servei de Medicina Preventiva, Vall d'Hebron Hospital, Universitat Autónoma de Barcelona, Spain.
Vaqué
J
J
Rosselló
J
J
Salcedo
S
S
Durán
M
M
Monge
V
V
García Caballero
J
J
Sáenz
M C
MC
Calbo
F
F
Armadans
L
L
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