{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T11:31:26Z","timestamp":1753356686885,"version":"3.37.3"},"reference-count":23,"publisher":"FapUNIFESP (SciELO)","issue":"8","license":[{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  INTRODUCTION  Healthcare associated infections (HAI) are the most frequent complication of hospitalized patients. The aim of this study was to describe the clinical and epidemiological characteristics of critically ill post-surgical patients with a diagnosis of healthcare associated infections, after a pattern of sedoanalgesia of at least 4 days.  METHODS  All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. The study population was the one affected by surgical pathology where sedation was based as analgesic the opioid remifentanil for at least 96 hours in continuous perfusion. Patients who died during admission to the unit and those with combined analgesia (peripheral or neuroaxial blocks) were excluded. Data analysis was performed using the statistical package Stata version 7.0.  RESULTS  The patients admitted to the Post-Surgical Critical Care Unit (PCU) during study were 1789 and the population eligible was comprised of 102 patients. 56.86% of patients suffered IACS. The most frequent IACS was pneumonia associated with mechanical ventilation (30.96 per 1000 days of mechanical ventilation), Pseudomonas aeruginosa being the most frequently isolated germ. The germs with the greatest involvement in multiple drug resistance (MDROs) were enterobacteria, mainly Klebsiella pneumoniae resistant to extended-spectrum beta-lactamases (ESBL).  CONCLUSIONS  Pneumonia associated with mechanical ventilation is the most prevalent HAI and Pseudomonas aeruginosa is the main etiological agent. The groups of antibiotics most frequently used were cephalosporin and aminoglycosides. It is necessary to implement the prevention strategies of the different HAI, since most of them are avoidable.<\/jats:p>","DOI":"10.1590\/1806-9282.64.08.736","type":"journal-article","created":{"date-parts":[[2018,11,24]],"date-time":"2018-11-24T18:12:58Z","timestamp":1543083178000},"page":"736-742","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of post-surgical critical patients with infections associated with healthcare after prolonged perfusion of remifentanil"],"prefix":"10.1590","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2878-7875","authenticated-orcid":false,"given":"Jos\u00e9 Luis Bonilla","family":"Garc\u00eda","sequence":"first","affiliation":[{"name":"Complejo Hospitalario Universitario de Huelva,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel Corti\u00f1as","family":"S\u00e1enz","sequence":"additional","affiliation":[{"name":"Hospital Torrec\u00e1rdenas de Almer\u00eda,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esperanza del Pozo","family":"Gavil\u00e1n","sequence":"additional","affiliation":[{"name":"Universidad de Granada,  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2018,8]]},"reference":[{"series-title":"CDC\/NHSN Identifying healthcare-associated infections (HAI) for NHSN Surveillance","key":"ref1"},{"year":"2015","series-title":"Estudio EPINE-EPPS","key":"ref2"},{"issue":"2","key":"ref3","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.eimc.2013.01.001","article-title":"General epidemiology of nosocomial infections. 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relevancia cl\u00ednica","volume":"62","author":"Garcia JBS","year":"2012","journal-title":"Rev Bras Anestesiol"},{"issue":"12","key":"ref8","doi-asserted-by":"crossref","first-page":"7953","DOI":"10.1128\/IAI.73.12.7953-7959.2005","article-title":"Increased sensitivity to Salmonella enterica serovar Typhimurium infection in mice undergoing withdrawal from morphine is associated with suppression of interleukin-12","volume":"73","author":"Feng P","year":"2005","journal-title":"Infect Immun"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"R60","DOI":"10.1186\/cc7788","article-title":"Remifentanil discontinuation and subsequent intensive care unit-acquired infection: a cohort study","volume":"13","author":"Nseir S","year":"2009","journal-title":"Crit Care"},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/00003246-200201000-00020","article-title":"Clinical practice guidelines for the sustained use of sedatives and analgesics 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