Brent et al developed the Serious Bacterial Infection (SBI) Score to identify a pediatric patient with a serious bacterial infection. This can help to identify a child who may benefit from more aggressive management. The authors are from Royal College of Paediatrics and Child Health, Imperial College London, University of Leicester, Institute of Health Sciences at Oxford, Oregon Helath & Science University, University of Nottingham and Great Ormond Street Hospital.
Patient selection: age range form 1 month to 15 years
A serious bacterial infection was defined as:
(1) positive bacterial culture from blood or normally sterile site in appropriate clinical context
(2) radiographic evidence of pneumonia
(3) clinical meningitis plus CSF neutrophilic leukocytosis
(4) acute febrile purpura
(5) deep collections requiring surgical drainage and/or intravenous antibiotics
(6) white blood cell count >= 20,000 per µL
(7) CRP >= 120 mg/L
(8) clinical diagnosis of septic arthritis, osteomyelitis, empyema or mastoiditis
Parameters:
(1) developmental delay
(2) risk factor(s) for infection (any condition known to increase the risk of an invasive bacterial infection)
(3) "state" variation
(4) temperature
(5) capillary refill time (CRT) in seconds
(6) hydration status
(7) respiratory rate (tachypnea)
(8) hypoxia
|
Parameter |
Finding |
Points |
|
developmental delay |
none |
0 |
|
|
present |
4 |
|
risk for infection |
absent |
0 |
|
|
present |
2 |
|
state variation |
eyes open |
0 |
|
|
eyes close briefly |
1 |
|
|
falls asleep |
2 |
|
temperature |
< 37.5°C |
0 |
|
|
37.5 to 38.4°C |
1 |
|
|
> 38.4°C |
2 |
|
capillary refill time |
< 2 seconds |
0 |
|
|
>= 2 seconds |
1 |
|
hydration status |
well-hydrated |
0 |
|
|
dry mucous membranes |
2 |
|
|
reduced skin turgor |
4 |
|
tachypnea |
absent |
0 |
|
|
present |
1 |
|
hypoxia |
none |
0 |
|
|
mild (SaO2 < 95%) |
1 |
|
|
severe (SaO2 < 90% or < 92% while on oxygen) |
2 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• The higher the score the greater the risk of a serious bacterial infection.
|
Total Score |
Risk Serious Bacterial Infection |
|
0 to 5 |
2% |
|
6 |
8% |
|
7 |
13% |
|
8 |
18% |
|
9 to 18 |
35% |
Specialty: Pedatrics
ICD-10: ,
