Etiology of hospital-acquired infections in Spanish hospitals (EPINE, 1990-1999)

被引:23
作者
Asensio, A
Cantón, R
Vaqué, J
Rosselló, J
Arribas, JL
机构
[1] Hosp Univ Puerta de Hierro, Serv Med Prevent, Madrid 28035, Spain
[2] Hosp Ramon y Cajal, E-28034 Madrid, Spain
[3] Hosp Gen Valle Hebron, Barcelona, Spain
[4] Hosp Miguel Servet, Zaragoza, Spain
来源
MEDICINA CLINICA | 2002年 / 118卷 / 19期
关键词
hospital-acquired infection; prevalence; etiology; methicillin-resistant Staphylococcus aureus;
D O I
10.1016/S0025-7753(02)72513-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. Patients and method: 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% Cl, 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-acquire infections increased steadily and their initial rates multiplied by 8 and 6, respectively. Rates of HI caused by yeasts and A. baumannii increased also.
引用
收藏
页码:725 / 730
页数:6
相关论文
共 16 条
[1]   Antimicrobial use in Spanish hospitals (EPINE, 1990-1999) [J].
Asensio, A ;
Cantón, R ;
Vaqué, J ;
Rosselló, J ;
Arribas, JL .
MEDICINA CLINICA, 2002, 118 (19) :731-736
[2]   The changing epidemiology of Staphylococcus aureus? [J].
Chambers, HF .
EMERGING INFECTIOUS DISEASES, 2001, 7 (02) :178-182
[3]  
Craven DE, 1997, INFECT CONT HOSP EP, V18, P783
[4]   A 25-year study of nosocomial bacteremia in an adult intensive care unit [J].
Edgeworth, JD ;
Treacher, DF ;
Eykyn, SJ .
CRITICAL CARE MEDICINE, 1999, 27 (08) :1421-1428
[5]  
Favero MS, 1996, AM J INFECT CONTROL, V24, P380
[6]   Antimicrobial resistance in intensive care units [J].
Fridkin, SK ;
Gaynes, RP .
CLINICS IN CHEST MEDICINE, 1999, 20 (02) :303-+
[7]   CDC DEFINITIONS FOR NOSOCOMIAL INFECTIONS, 1988 [J].
GARNER, JS ;
JARVIS, WR ;
EMORI, TG ;
HORAN, TC ;
HUGHES, JM .
AMERICAN JOURNAL OF INFECTION CONTROL, 1988, 16 (03) :128-140
[8]  
GEBERDING JL, 1999, CURR CLIN TOP INFECT, V19, P83
[9]   THE EFFICACY OF INFECTION SURVEILLANCE AND CONTROL PROGRAMS IN PREVENTING NOSOCOMIAL INFECTIONS IN UNITED-STATES HOSPITALS [J].
HALEY, RW ;
CULVER, DH ;
WHITE, JW ;
MORGAN, WM ;
EMORI, TG ;
MUNN, VP ;
HOOTON, TM .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1985, 121 (02) :182-205
[10]  
HORAN TC, 1992, INFECT CONT HOSP EP, V13, P606