关键词: 多重耐药菌, 医院-社区联动, 感染防控, ICU出院患者, 自我管理能力, 医疗资源消耗

Abstract: Objective To investigate the prevention and control efficacy of a hospital-community linkage model for patients with multidrug-resistant organism (MDRO) infection or colonization discharged from the intensive care unit (ICU). Methods A total of 226 MDRO-infected or colonized patients discharged from the ICU of the First Affiliated Hospital of Hebei North University between January 2023 and January 2025 were enrolled and allocated into a control group (n=113) and an intervention group (n=113). The control group received standard discharge instructions, whereas the intervention group was managed using a hospital-community linkage model (encompassing hospital-based assessment, stratified community follow-up, and bidirectional referral). The cumulative MDRO detection rate, infection incidence, self-management capability, unplanned readmission rates, and medical resource consumption were compared between the two cohorts at 1, 3, and 6 months post-discharge. Results At 1, 3, and 6 months post-discharge, the cumulative MDRO detection rates in the intervention group were 1.77%, 2.65%, and 3.54%, respectively, which were significantly lower than the 2.65%, 7.08%, and 10.52% observed in the control group (all P<0.05). The cumulative infection rates were 0.88%, 1.77%, and 1.77% in the intervention group versus 2.65%, 4.42%, and 4.42% in the control group, indicating no statistically significant difference (P>0.05). Following the intervention, both the dimension-specific and total scores for self-management in the intervention group were significantly superior to those of the control group (all P<0.05). Within the 6-month follow-up, the unplanned readmission rate in the intervention group was significantly lower than that in the control group (4.42% vs. 12.39%, P<0.05). Among the readmitted patients, there were no statistically significant differences in the frequency of readmissions or the length of hospital stay between the two groups (P>0.05); however, the total hospitalization expenditures were significantly lower in the intervention group [(0.49±0.16) vs. (1.00±0.58) ten thousand CNY, P<0.05]. Furthermore, the intervention group demonstrated an initial follow-up timeliness rate of 98.23%, a follow-up completion rate of 100%, a key measure execution rate of 94.12%, and a bidirectional referral success rate of 100%. Neither group exhibited adverse psychological states or disinfection-related adverse reactions. Conclusion The hospital-community linkage model effectively reduces the recurrent MDRO detection rate among ICU-discharged patients with MDRO infection or colonization. Additionally, it enhances patient self-management capabilities and decreases both readmission rates and hospitalization costs, thereby demonstrating substantial value for broader clinical application.

Key words: Multidrug-resistant organisms, Hospital-community integration, Infection prevention and control, ICU discharge patients, Self-management ability, Medical resource consumption