The Pitt Bacteremia Score Predicts Mortality in Nonbacteremic Infections

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

研究成果: Article

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BACKGROUND: Predicting mortality risk in patients is important in research settings. The Pitt bacteremia score (PBS) is commonly used as a predictor of early mortality risk in patients with bloodstream infections (BSIs). We determined whether the PBS predicts 14-day inpatient mortality in nonbacteremia carbapenem-resistant Enterobacteriaceae (CRE) infections. METHODS: Patients were selected from the Consortium on Resistance Against Carbapenems in Klebsiella and Other Enterobacteriaceae, a prospective, multicenter, observational study. We estimated risk ratios to analyze the predictive ability of the PBS overall and each of its components individually. We analyzed each component of the PBS in the prediction of mortality, assessed the appropriate cutoff value for the dichotomized score, and compared the predictive ability of the qPitt score to that of the PBS. RESULTS: In a cohort of 475 patients with CRE infections, a PBS ≥4 was associated with mortality in patients with nonbacteremia infections (risk ratio [RR], 21.9; 95% confidence interval [CI], 7.0, 68.8) and with BSIs (RR, 6.0; 95% CI, 2.5, 14.4). In multivariable analysis, the hypotension, mechanical ventilation, mental status, and cardiac arrest parameters of the PBS were independent risk factors for 14-day all-cause inpatient mortality. The temperature parameter as originally calculated for the PBS was not independently associated with mortality. However, a temperature <36.0°C vs ≥36°C was independently associated with mortality. A qPitt score ≥2 had similar discrimination as a PBS ≥4 in nonbacteremia infections. CONCLUSIONS: Here, we validated that the PBS and qPitt score can be used as reliable predictors of mortality in nonbacteremia CRE infections.

元の言語English
ページ(範囲)1826-1833
ページ数8
ジャーナルClinical infectious diseases : an official publication of the Infectious Diseases Society of America
70
発行部数9
DOI
出版物ステータスPublished - 15-04-2020

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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    Henderson, H., Luterbach, C. L., Cober, E., Richter, S. S., Salata, R. A., Kalayjian, R. C., Watkins, R. R., Doi, Y., Kaye, K. S., Evans, S., Fowler, V. G., Bonomo, R. A., Harris, A., Napravnik, S., & Van Duin, D. (2020). The Pitt Bacteremia Score Predicts Mortality in Nonbacteremic Infections. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 70(9), 1826-1833. https://doi.org/10.1093/cid/ciz528