title: [Etiology of hospital-acquired infections in Spanish hospitals (EPINE, 1990-1999)].
abstract: BACKGROUND
  Clinical and demographic characteristics of patients, their interaction with pathogens and antimicrobial therapies are prompting changes in the epidemiology of hospital-acquired infections (HI). The knowledge of the etiology of hospital-acquired infections is valuable for the treatment of infected patients and for the prevention of HI.
  
  
  METHODS
  We analyzed a series of 10 annual prevalence studies during the period 1990-1999 (EPINE project) in Spanish hospitals. Estimate of prevalence of infection was calculated by means of the percent distribution of every organism regarding overall identified organisms and infections.
  
  
  RESULTS
  40,550 HI were identified among 484,013 patients (HI prevalence = 8.4%; 95% CI, 8.3-8.5%). Gram-positive organism predominated steadily in bloodstream and surgical wound infections, while gram-negative bacilli predominated in respiratory and urinary tract infections. There was an increase in HI infections by Acinetobacter baumannii (from 1.9% in 1990 to 3.6% in 1999; P < 0.001) and Candida albicans (from 2.4 to 3.2%; P < 0.001), as well as an increase in both HI and community-acquired infections by methicillin-resistant Staphylococcus aureus [HI: from 4.7 to 40.2% (P < 0.001); community-acquired: from 2.7 to 15.6% (P < 0.001)].
  
  
  CONCLUSIONS
  We observed some changes in the etiology of infections over the last decade: rates of methicillin-resistant S. aureus hospital-acquired and community-acquired infections increased steadily and their initial rates multiplied by 8 and 6, respectively. Rates of HI caused by yeasts and A. baumannii increased also.
authors.affiliation: Hospital Universitario Puerta de Hierro, Madrid, Spain. a_asensio@retemail.es
authors.forename: Angel
authors.initials: A
authors.lastname: Asensio
authors.forename: Rafael
authors.initials: R
authors.lastname: Cantón
authors.forename: Josep
authors.initials: J
authors.lastname: Vaqué
authors.forename: José
authors.initials: J
authors.lastname: Rosselló
authors.forename: José Luis
authors.initials: JL
authors.lastname: Arribas
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D015995:Prevalence; D013030:Spain
vernacular_title: Etiología de las infecciones hospitalarias en España (EPINE, 1990-1999).