The Pitt Bacteremia Score Predicts Mortality in Non-Bacteremic Infections.

The Pitt Bacteremia Score Predicts Mortality in Non-Bacteremic Infections.

Henderson Heather; Luterbach Courtney L; Cober Eric; Richter Sandra S; Salata Robert A; Kalayjian Robert C; Watkins Richard R; Doi Yohei; Kaye Keith S; Evans Scott; Fowler Vance G; Bonomo Robert A; Harris Anthony; Napravnik Sonia; van Duin David

Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America

2019

2019-06

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 (BSI). Here, we determined whether the PBS predicts 14-day inpatient mortality in non-bacteremia carbapenem-resistant Enterobacteriaceae (CRE) infections.; Methods: Patients were selected from the Consortium on resistance against carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE-1), 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 non-bacteremia infections (RR=21.9 [95% CI: 7.0, 68.8]) and with BSI (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 < 36.0ᴼ C versus ≥ 36ᴼ C was independently associated with mortality. A qPitt score ≥ 2 had similar discrimination as a PBS ≥ 4 in non-bacteremia infections.; Conclusion: Here, we validated that the PBS and qPitt score can be used as reliable predictors of mortality in non-bacteremia CRE infections.; © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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