Effect of multi-disciplinary team management mode on the control of car-bapenem-resistant Enterobacterales infection after lung transplant surgery
10.12138/j.issn.1671-9638.20256918
- VernacularTitle:肺移植术后多学科协作管理模式对耐碳青霉烯类肠杆菌感染控制的效果分析
- Author:
Yuqing GONG
1
;
Sangsang QIU
1
;
Qinhong HUANG
1
;
Mengjing CHEN
1
;
Qinfen XU
1
Author Information
1. 南京医科大学附属无锡人民医院感染管理处,江苏无锡 214023
- Publication Type:Journal Article
- Keywords:
lung transplant;
carbapenem-resistant Enterobacterales;
healthcare-associated infection;
multi-disci-plinary team
- From:
Chinese Journal of Infection Control
2025;24(8):1089-1096
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of multi-disciplinary team(MDT)management mode on the preven-tion and control of carbapenem-resistant Enterobacterales(CRE)infection after lung transplant surgery,and explore the influencing factors for CRE infection after lung transplant.Methods A total of 654 lung transplant recipients from Lung Transplant Center of Wuxi People's Hospital from January 2014 to July 2023 were selected as the re-search subjects.According to the time nodes of the implementation of MDT management mode,lung transplant re-cipients from January 2014 to December 2019 were assigned to the control group without implementation of MDT management mode.Lung transplant recipients from January 2020 to July 2023 were in the intervention group with MDT management mode implementation.Kaplan-Meier method was used to calculate the risk of CRE infection in lung transplant recipients 90 days after surgery.Cox regression model was used to adjust variables such as length of hospital stay,surgical duration,and catheterization days of three catheters,and the effect of implementing MDT management mode on the risk of CRE infection was analyzed.Results Among 654 lung transplant recipients,215 had healthcare-associated infection(HAI),including 158 cases from the control group and 57 from the intervention group,with HAI rates of 38.54％and 23.36％,respectively.The incidence of HAI in lung transplant recipients in the intervention group was lower than that in the control group(x2=15.965,P＜0.001).A total of 74 cases of CRE infection were confirmed,and CRE infection rate in the intervention group was lower than that in the control group(7.79％[19/244]vs 13.41％[55/410];x2=4.828,P=0.028).By the end of the 90-day follow-up period,the cumulative infection risks of the control group and intervention group were 14.67％and 8.26％,respectively,with a statistically significant difference between the two groups(P＜0.05).The implementation of MDT manage-ment mode was a protective factor for post-operative CRE infection in lung transplant recipients,while duration of surgery,duration of ventilator use,and duration of urinary catheterization were risk factors for CRE infection(all P＜0.05).Conclusion Implementing MDT management mode in lung transplant recipients can effectively reduce the risk of post-operative CRE infection.Continuously standardizing and implementing MDT management of multidrug-resistant organisms in hospitals is an important mean of preventing CRE infection and controlling transmission.
