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[Annual incidence and control of nosocomial infections in a county hospital].

BACKGROUND
The recommendation of Centers for Disease Control that hospitals must have a person trained in infection control per 250 beds has been understood as a law of all or nothing hindering implementation of hospital infection surveillance and control programs in small hospitals. Since the importance that small regional hospitals have in the Spanish Health System, the aim of this study is to describe the magnitude and characteristics of nosocomial infections (NI) in a small regional hospital in case this position needs being reconsidered.


METHODS
The study was carried in Hospital de Calatayud, a small regional hospital of 122 beds belonging to Health Area III of Aragon. All the NI that occurred during 1992 were recorded by means of an uninterrupted system of prospective surveillance based on a multirecord revision. Both of the Accumulate Incidence of NI (AINI) and Accumulate Incidence of Patients with one or more NI (AINP) were calculated and the main variables associated with NI were described.


RESULTS
Altogether, 298 NI were detected in 242 patients during that year. The AINI was 7.1% and the AINP was 5.8% with a mean of 1.2 (SD = 0.6) HI per infected patient. The most frequent types of NI were urinary tract infection, surgical wound infection and lower respiratory tract infection. Some pathogen microorganism were identified in 43% of NI. The microorganisms most frequently associated with NI were Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. Mortality associated with NI was 11% and the average stay of patients with some NI was 22.9 days (SD = 22.1).


CONCLUSIONS
Results point out the need for implementing hospital infections surveillance and control programs in small hospitals too.