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Clinical Pulmonary Infection Score (CPIS)

 

Patient temperature
		≥36.5 degrees C and ≤38.4 degrees C (0 points)
		≥38.5 degrees C and ≤38.9 degrees C (1 point)
		≥39 degrees C (2 points)
		≤36 degrees C (2 points)
WBC
		≥4,000/mm-3 and ≤11,000/mm-3 (0 points)
		<4,000/mm-3 or >11,000/mm-3 (1 point)
		<4,000/mm-3 or >11,000/mm-3 with ≥500 bands (2 points)
Tracheal secretions (0-4+ quantifications summed over 24 hours)
		<14+ (0 points)
		≥14+ (1 point)
		≥14+ and purulent (2 points)
PaO2(mmHg)/FIO2
		>240 or ARDS present (0 points)
		≤240 or no ARDS present (2 points)
Chest X-Ray
		No infiltrate (0 points)
		Patchy or diffuse infiltrate (1 point)
		Distinct infiltrate (2 points)
Quantitative pathogenic bacterial culture growth from tracheal aspirate
		≤1+ or no growth (0 points)
		>1+ (1 point)
		>1+ and same bacteria seen on gram stain (2 points)

 
Important: Inputs must be complete to perform calculation.

 

Total Criteria Point Count:
 

 

CPIS Interpretation

 

0 to 6 points:	Pneumonia less likely
7 to 12 points:	Pneumonia more likely

 

 

Data action

 

     
 
Include literature references: Yes   No

Notes

• The CPIS is used in the diagnosis of ventilator associated pneumonia.

 

References

1. Pugin J, Auckenthaler R, Mili N, et al. Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic "blind" bronchoalveolar lavage fluid. Am Rev Respir Dis. 1991 May;143(5 Pt 1):1121-9. PubMed ID: 2024824
2. Rosbolt MB, Sterling ES, Fahy BG. The utility of the clinical pulmonary infection score. J Intensive Care Med. 2009 Jan-Feb;24(1):26-34. doi: 10.1177/0885066608327097. Epub 2008 Nov 19. Review. PubMed ID: 19019839
3. Singh N, Rogers P, Atwood CW, et al. Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit. A proposed solution for indiscriminate antibiotic prescription. Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):505-11. PubMed ID: 10934078

 

Associated Medical Subject Headings [MeSH]
 

Adult,   Aged,   Anti-Bacterial Agents,   Anti-Infective Agents,   Artificial,   Bacterial Infections,   Bronchoalveolar Lavage Fluid,   Bronchoscopy,   Ciprofloxacin,   Cross Infection,   Drug Resistance,   Female,   Humans,   Intensive Care Units,   Length of Stay,   Male,   Microbial,   Middle Aged,   Pneumonia,   Practice Guidelines as Topic,   Predictive Value of Tests,   Reproducibility of Results,   Respiration,   Sensitivity and Specificity,   Severity of Illness Index,   Specimen Handling,   Ventilator-Associated

 

Associated ICD10-CM Codes
 

	I27.82	Chronic pulmonary embolism
	I50.9	Heart failure, unspecified
	J18.0	Bronchopneumonia, unspecified organism

 

Associated ICD9-CM Codes
 

	482.9	Bacterial pneumonia nos
	485	Bronchopneumonia org nos
	481	Pneumococcal pneumonia
	480.9	Viral pneumonia nos