The isolation implementation rate is still unsatisfactory. The overall isolation implementation rate of this study was 66.12%, 33.12% before intervention, and 75.88% after intervention, both of which were lower than the standards for isolation in the United States. Compared with research by Xu Chuan  (the isolation order issuance rate was 75.1% before the intervention, 95.36% after the intervention) and Liang Yanfang  (the isolation order issuance rate was 74.07% before the intervention, 98.48% after the intervention), their isolation implementation rate was higher than our research mainly because we included not only Patients with MDRO infection, but also colonized patients. Before the intervention, the number of colonized patients was more than the infected patients (269vs190) but the implementation rate was lower (30.9% vs 36.3%); after the intervention, the number of colonized patients was less than the infected patients (408vs471) but the implementation rate was higher (77% vs74.9%), the application effect of multidisciplinary collaborative intervention on colonized patients is better than that of infected patients, which reflects the necessity of the study to include colonized patients. However, in the actual implementation of isolation prevention and control measures, medical personnel generally do not attach importance to colonized patients as high as infected patients, resulting in a relatively low probability of colonization patients being taken isolation measures (58.64% vs 63.84%), so the overall isolation implementation rate after intervention in this study is still low. In addition, due to the low baseline level of isolation implementation rate before intervention, the isolation implementation rate after intervention is still not high in the short term, but the increased rate is the highest among the three studies, indicating that this study has achieved great intervention results from the perspective of the increase in isolation implementation rate. Research hospital should continue to strengthen the implementation of isolation measures for patients with MDRO infection and colonization.
Multidisciplinary collaborative intervention can increase the implementation rate of isolation. After taking multidisciplinary collaborative interventions, the implementation rate of issuing isolation orders is significant (P < 0.000). A meta-analysis  on the effects of multi-disciplinary collaborative intervention on the prevention and control of multi-drug resistant infections included eight RCTs, four of them reported the implementation of contact isolation precautions for patients with MDRO infection, the results show that the implementation rate of isolation in patients with MDT is higher than the control group (OR = 4.40, 95% CI 3.53 to 5.47), therefore, multidisciplinary collaboration mode can significantly improve the isolation implementation rate. There are literatures describing several interventions that have successfully prevented and controlled the spread of MDROs [23–24], although it is not clear which measures are truly effective, there are suggestions that multiple modes of intervention can effectively improve the implementation rate of isolation measures [25–26], thereby reducing the incidence of MDRO infection.
The factors that affect the implementation rate of isolation also include the patients’ department. Different departments have different possibilities of causing MDRO infections. For example, surgical patients have more surgical wounds, while medical patients have more invasive procedures, catheterization and mechanical ventilation are important risk factors for multi-drug resistant infections [27–28], especially when the patient is in the ICU, doctors will pay more attention to the isolation and prevention of these patients. An observational study of three locations in the New York City hospital network on contact isolation precautions also found that in the ICUs, the compliance rate of all isolation prevention and control measures was significantly higher than that of non-ICUs .
LOS more than 15 days also affect the isolation implementation rate because the LOS is related to MDRO infection. On the one hand, patients with more hospital stays have more serious condition, with low immunity and more invasive procedures, which increases the possibility of MDRO infections. On the other hand, MDRO infection will prolong the hospital stays of patients . A study on the impact of hospital infections on the LOS in 68 hospitals in China found that MDRO infection increased the average LOS by one day, and the maximum number of days for CR-PA infection increased by 26 days . Langeveld  also found that the MDRO group had an average of 25 more hospital stays than the non-resistant group. More hospital stays will not only increase the infection rate, but also increase the mortality rate. Therefore, for patients with more hospital stays, doctors are more likely to take isolation prevention and control measures.
Our study has several limitations. Firstly, our research is single-centered. Then, our intervention patients come from different periods, there may be time or other confounding factors that introduced bias. In addition, this is an observational study that we cannot prove the cause and effect, nor can we speculate whether the patient’s clinical outcome has improved through the effect of intervention on the implementation of isolation. Finally, although the implementation rate of isolation measures has been significantly improved in this study, the overall situation is still not ideal, this may be because our study only considered ten months before and after the intervention, and also indicated that there may be medical personnel themselves and external influencing factors but we haven’t conducted relevant investigations.