Pitt bacteremia score

From IDWiki

Background

  • Originally developed to predict mortality with Pseudomonas aeruginosa bacteremia
  • Now used more broadly for mortality from infections more generally
  • A modified Pitt bacteremia score (mPBS) also exists[1]

Components

  • Measured at onset of bacteremia
Criterion Points (original) Points (modified)
Fever (°C)
    ≤35 or ≥40 2
    35.1-36.0 or 39.0-39.9 1
    36.1-38.9 0
Hypotension: drop by >30 SBP or >20 DBP, or vasopressors, or SBP <90 2 2
Mechanical ventilation 2 2
Cardiac arrest 4 4
Mental status
    Alert 0 0
    Disoriented 1 1
    Stuporous/comatose 2 2
    Comatose 4 4
Dialysis 2

Interpretation

  • ≥4 usually used as a cutoff for increased risk of death
Mortality predicted by PBS for various infections.
Score Gram-negative bacteremia (28-day mortality)[2] SAB (30-day mortality)[3] Nonbacteremic infections (14-day mortality)[4] Candidemia (mPBS) (30-day mortality)[1]
0 ≤1% 8% 5% 14%
1 1% 5%
2 1.5% 15%
3 2% 40%
4 3% 47% 40% 37%
5 5% 33%
6 7% 43%
7 10% 75%
8 14% 69%
9 20%
≥10 27-81%
  1. 1.0 1.1 Nakada-Motokawa, N, Miyazaki, T, Ueda, T, et al. Modified Pitt bacteremia score for predicting mortality in patients with candidaemia: A multicentre seven-year retrospective study conducted in Japan. Mycoses. 2021; 64: 1498-1507. https://doi.org/10.1111/myc.13380
  2. Al-Hasan MN, Lahr BD, Eckel-Passow JE, Baddour LM. Predictive scoring model of mortality in Gram-negative bloodstream infection. Clin Microbiol Infect. 2013 Oct;19(10):948-54. doi: 10.1111/1469-0691.12085. Epub 2012 Nov 27. PMID: 23190091.
  3. Roth JA, Tschudin-Sutter S, Dangel M, Frei R, Battegay M, Widmer AF. Value of the Pitt Bacteraemia Score to predict short-term mortality in Staphylococcus aureus bloodstream infection: a validation study. Swiss Med Wkly [Internet]. 2017 Aug. 10 [cited 2023 Feb. 8];147(3132):w14482. Available from: https://smw.ch/index.php/smw/article/view/2342
  4. Heather Henderson, Courtney L Luterbach, Eric Cober, Sandra S Richter, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Yohei Doi, Keith S Kaye, Scott Evans, Vance G Fowler, Jr, Robert A Bonomo, Anthony Harris, Sonia Napravnik, David Van Duin, The Pitt Bacteremia Score Predicts Mortality in Nonbacteremic Infections, Clinical Infectious Diseases, Volume 70, Issue 9, 1 May 2020, Pages 1826–1833, https://doi.org/10.1093/cid/ciz528