Three hospital-acquired infections rates appear to be lower in patients admitted to a “closed” intensive care unit, meaning that the ICU team has primary responsibility for the patient, rather than a primary care physician, according to research presented at ATS 2019.
Researchers found reduced rates in central line-associated blood stream infections (CLABSI), catheter-associated urinary tract infections (CAUTI) and ventilator-acquired pneumonia (VAP) after one facility transitioned from an open to a closed ICU.
There was a:

  • 19.3% reduction in CLABSI rate (1.71/1,000 catheter-days in open ICU vs 0.33/1,000 catheter-days in closed ICU),
  • 100% reduction in CAUTI rate (2.1/1,000 catheter-days in open ICU vs 0/1,000 catheter-days in closed ICU)
  • 100% reduction in VAP (1.9/1,000 ventilator-days in open ICU vs 0/1,000 ventilator-days in closed ICU)

However, methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. Diff) rates remained the same.

  • C Diff infections (1.49/1,000 patient-days in open ICU vs 2.94/1,000 patient-days in closed ICU)
  • MRSA blood infection (0.38/1,000 patient-days in open ICU vs 0.44/1,000 patient-days in closed ICU)

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