Healthcare-associated infections cause more than 5,000 deaths per year in Spain

The latest data from the EPINE study reveal that HAIs affect 7.3% of hospitalized patients and warn of an increase in infections caused by multidrug-resistant microorganisms.

Madrid, October 26, 2026

Healthcare-associated infections (HAIs) continue to be one of the main patient safety issues in Spanish hospitals. According to new findings from the EPINE study, an estimated 5,067 people die each year in Spain from causes attributable to these infections—a figure three times higher than the number of deaths from traffic accidents.

These data were presented at the scientific conference “EPINE 2026: Surveillance, Resistance, and Antimicrobial Use,” held on October 22 at La Princesa University Hospital in Madrid, organized as part of the EPINE study by the Spanish Society of Preventive Medicine, Public Health, and Health Management (SEMPSPGS).

Hospital-acquired infections continue to have a significant impact on mortality

The results for the 2022–2026 period, presented by Clara Salamanca Ávila, show that 7.3% of hospitalized patients have a healthcare-associated infection.

An analysis of more than 280,000 patients shows that those with a healthcare-associated infection (HAIs) are more likely to die than those without these infections, even after adjusting for age, sex, severity of the underlying disease, and hospital size. The infections associated with the highest number of deaths are respiratory infections and bacteremias.

These estimates highlight the need to strengthen infection prevention and control strategies, especially considering that a significant proportion of these complications can be prevented.

Antimicrobial resistance poses an additional risk to patients

Another finding presented during the conference, by Lina M. Parra Ramírez, shows that infections caused by multidrug-resistant microorganisms have increased in recent years, reaching a prevalence of 2.35% among hospitalized patients in 2026.

The study shows that infections caused by resistant microorganisms are associated with higher mortality than those caused by susceptible strains, with an estimated 986 deaths per year attributable to excess mortality associated with the resistance profiles studied.

Another relevant finding is the growing prevalence of infections caused by multidrug-resistant microorganisms classified as community-acquired among hospitalized patients. This trend reinforces the need to address antimicrobial resistance in a coordinated manner across different healthcare settings.

These findings reinforce the importance of preventing infections, avoiding the transmission of resistant microorganisms, and optimizing the use of antimicrobials.

More than a Decade of PROA: Significant Progress, but High Antibiotic Use Persists

The conference also addressed the evolution of antimicrobial stewardship programs (PROA) in Spain, based on an analysis presented by Elena Jiménez Tejero, which compiles data from more than 800,000 patients.

The results reflect a positive trend in the resources and structures dedicated to PROAs, as well as improvements in certain prescribing practices.

However, approximately 45% of hospitalized patients continue to receive antimicrobials, while the use of broad-spectrum antibiotics is on the rise.

EPINE Takes a New Step Toward Evaluating the Quality of Antibiotic Prescribing

With the goal of improving the quality of prescribing, EPINE conducted a pilot study in 2026, presented by José María Gutiérrez Urbón, in which 15 hospitals evaluated 1,312 antimicrobial prescriptions.

The results show a prescription compliance rate of 58%. The main areas for improvement are identified as the choice of antimicrobial, the documentation of the treatment plan in the medical record, and the duration of treatments.

This initiative will enable progress toward a standardized evaluation of treatment appropriateness, with the goal of gradually expanding it to the rest of the participating hospitals.

Prevention: A Priority for Improving Patient Safety

The EPINE results highlight the need to promote a joint strategy based on epidemiological surveillance, infection prevention and control, and the optimization of antimicrobial use.

Preventing infections not only reduces complications, prolonged hospital stays, and deaths, but also decreases the need for antibiotics and helps curb the emergence and spread of antibiotic resistance.