NOSOCOMIAL INFECTIONS IN SPAIN - RESULTS OF 5 NATIONWIDE SERIAL PREVALENCE SURVEYS (EPINE PROJECT, 1990 TO 1994)

OBJECTIVE: To determine trends in rates of nosocomial infections in Sp anish hospitals. DESIGN: Prospective prevalence studies, performed yea rly from 1990 through 1994. SETTING: A convenience sample of acute-car e Spanish hospitals. PARTICIPANTS AND PATIENTS: The number of hospital s and patients included were as follows: 1990, 125 hospitals and 38,48 9 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 par ticipated in all five surveys and included a mean of 23,871 patients p er year, was analyzed separately. RESULTS: The overall prevalence rate of patients with nosocomial infections in the five studies was as fol lows: 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%, respectiv ely (test for trend, P=.0001). Patients admitted to intensive-care uni ts had a 22.8% prevalence rate of nosocomial infection in 1994. The mo st common nosocomial infections by primary site were urinary tract inf ection and surgical site infections, followed by respiratory tract inf ections and bacteremia. More than 60% of all infections were supported by a microbiological diagnosis. CONCLUSIONS: The EPINE project provid es a uniform tool for performing limited surveillance of nosocomial in fections in most Spanish acute-care hospitals. Its use helps to spread an accepted set of definitions and methods for nosocomial infection c ontrol in the Spanish healthcare system. The surveys indicated that th e prevalence of nosocomial infections has been reduced over the last 5 years in a core sample of Spanish hospitals (Infect Control Hosp Epid emiol 1996;17:293-297).