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Nosocomial infections in pediatric patients: a prevalence study in Spanish hospitals. EPINE Working Group
M Campins1, J Vaqué, J Rosselló
1Servei de Medicina Preventiva, Vall d'Hebron Hospital, Universitat Autónoma de Barcelona, Spain.
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.