How is post-mortem microbiology appraised by pathologists? Results from a practice survey conducted by ESGFOR
Post-mortem microbiology (PMM) is an important tool in forensic pathology, assisting to determine the cause and manner of death. However, there is a lack of standardisation of PMM sampling. In order to get a better insight into the methods used, the available technical options and developmental needs, ESCMID Study Group for Forensic and Postmortem Microbiology (ESGFOR) members designed a survey aimed at pathologists regarding common practices of PMM in clinical and forensic autopsies. Multiple choice questions were developed based on Cumulative Techniques and Procedures in Clinical Microbiology (Cumitech). The questionnaire was sent to pathologists mainly across Europe and Turkey using SurveyMonkey. The survey had 147 respondents. Although all pathologists were aware of the existence of PMM, 39% (19/49) of the participants were not using it. The three main indications for PMM were: (i) clinical suspicion of an infection not confirmed antemortem (83%), (ii) infectious signs at autopsy (83%) and (iii) as part of a standard protocol for foetal/perinatal or paediatric death (67%). Almost 80% of the participants using PMM stated taking 1–10 samples per case. Of the requested examinations, a general bacteriological culture (96%) and a specific polymerase chain reaction (PCR) assay for a particular infectious agent (34%) were most popular. The most frequent samples were: heart blood (66%), peripheral femoral blood (49%), spleen (64%) and lung (56%). Eighty-nine percent of the participants considered PMM a useful resource when investigating the cause of death. Although there are some common uses, this survey indicates that there is a need for improvement towards standardising sampling procedures in PMM.
- 1.Caplan MJ, Koontz FP (2001) Cumitech 35, postmortem microbiology. Coordinating editor: BW McCurdy. ASM Press, Washington D.C.Google Scholar
- 3.Nolte KB, Fischer M, Reagan S, Lynfield R; Members of the National Association of Medical Examiners (NAME) Ad Hoc Committee for Bioterrorism and Infectious Diseases (2010) Guidelines to implement medical examiner/coroner-based surveillance for fatal infectious diseases and bioterrorism (“Med-X”). Am J Forensic Med Pathol 31:308–312CrossRefPubMedGoogle Scholar
- 6.Rambaud C, Roux AL, Saegeman V (2012) Microbiological examination of post-mortem samples. In: ESCMID-SFM Manual of microbiology, 1st edn, pp 255–261Google Scholar
- 8.Fernández-Rodríguez A, Cohen MC, Lucena J, Van de Voorde W, Angelini A, Ziyade N, Saegeman V (2015) How to optimise the yield of forensic and clinical post-mortem microbiology with an adequate sampling: a proposal for standardisation. Eur J Clin Microbiol Infect Dis 34(5):1045–1057. doi:10.1007/s10096-015-2317-x CrossRefPubMedGoogle Scholar