Bacteriological investigation—significance of time lapse after death

• Published in: European journal of clinical microbiology & infectious diseases Vol. 28; no. 10; pp. 1191 - 1198
• Main Authors: Lobmaier, I. V. K., Vege, Å., Gaustad, P., Rognum, T. O.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.10.2009; Springer; Springer Nature B.V
• Subjects: Autopsies; Autopsy; Bacteria; Bacterial Infections - blood; Bacterial Infections - cerebrospinal fluid; Bacterial Infections - mortality; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Blood; Blood culture; Cause of Death; Cerebrospinal fluid; Children; Forensic medicine; Heart; Hospitals; Humans; Illnesses; Infant; Infant Mortality; Infant, Newborn; Infants; Infectious diseases; Internal Medicine; Kidney - microbiology; Kidney - pathology; Lactose; Liver - microbiology; Liver - pathology; Logistic Models; Lung; Lung - microbiology; Lung - pathology; Lungs; Medical Microbiology; Medical sciences; Mortality; Spleen - microbiology; Spleen - pathology; Sudden Infant Death - etiology; Sudden Infant Death - pathology; Sudis; Time Factors; Blood Culture Bottle; Autopsy Sample; Pathogenic Bacterium; Blood Culture; Sudden Infant Death Syndrome; Infection; Microbiological investigation; Prognosis; Microbiology; Bacteriological investigation; Mortality
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/s10096-009-0762-0

In cases of sudden unexpected death in infants and children (SUDI), microbiological investigation has been an important part of the autopsy protocol at the University of Oslo for the last 15 years. The purpose of this study was to compare the microbiological findings in samples taken at hospital admittance shortly after death and at autopsy. Blood cultures and cerebrospinal fluid (CSF) were collected both at the hospital and at autopsy; organ samples were additionally collected at autopsy. Hospital samples were collected at a median of 4.5 h (95% confidence interval [CI] 3.25–5) and autopsy samples at a median of 24.25 h (95% CI 22–25.5) after death. The proportion of positive cultures was stable over time; the post mortal time had no influence on bacterial growth. As long as the autopsy is performed within 48 h after death, prior microbiological examination is unnecessary. Blood culture, CSF and lung specimens are the best predictors in our study.