[Etiology of hospital-acquired infections in Spanish hospitals (EPINE, 1990-1999)].
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.
Asensio
Angel
A
Hospital Universitario Puerta de Hierro, Madrid, Spain. a_asensio@retemail.es
Cantón
Rafael
R
Vaqué
Josep
J
Rosselló
José
J
Arribas
José Luis
JL
D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D015995:Prevalence; D013030:Spain
Etiología de las infecciones hospitalarias en España (EPINE, 1990-1999).