Pitt bacteremia score

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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 exists1

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%

References

  1. a b  Nana Nakada‐Motokawa, Taiga Miyazaki, Takashi Ueda, Yuka Yamagishi, Koichi Yamada, Hideki Kawamura, Hiroshi Kakeya, Hiroshi Mukae, Hiroshige Mikamo, Yoshio Takesue, Shigeru Kohno. Modified Pitt bacteremia score for predicting mortality in patients with candidaemia: A multicentre seven‐year retrospective study conducted in Japan. Mycoses. 2021;64(12):1498-1507. doi:10.1111/myc.13380.
  2. ^  M.N. Al-Hasan, B.D. Lahr, J.E. Eckel-Passow, L.M. Baddour. Predictive scoring model of mortality in Gram-negative bloodstream infection. Clinical Microbiology and Infection. 2013;19(10):948-954. doi:10.1111/1469-0691.12085.
  3. ^ 10.4414/smw.2017.14482 
  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, Robert A Bonomo, Anthony Harris, Sonia Napravnik, David Van Duin. The Pitt Bacteremia Score Predicts Mortality in Nonbacteremic Infections. Clinical Infectious Diseases. 2019;70(9):1826-1833. doi:10.1093/cid/ciz528.