A FORENSIC STUDY OF CULTIVATING POSTMORTEM HEART BLOOD IN 131 AUTOPSIES SUSPECTED OF INFECTIOUS DISEASES

Z. Zheng, L. Zhang, C. Zhao, H. Xiong, Y. Li, M. Zhao, J. Li

Abstract: With the inception of evidence-based medicine in the 19th century, the value of postmortem microbial culture has been controversial. Even so, it still plays an important role in the diagnosis of infectious death in modern forensic medicine. In this study, we performed a retrospective study of postmortem heart blood microbial culture for 131 autopsies suspected of infectious diseases. We analyzed the correlations between the various influencing factors, blood culture results and pathological findings. The results showed that there were 79 (60.3%) positive cultures and 52 (39.7%) negative cultures. Except for gender (P=0.02), no significant difference between positive cultures and negative cultures for age (P=0.06), prior antibiotics therapy (P=0.49), leukocyte count (P=0.77), neutrophil percentage (P=0.86), survival time (P=0.10) and PMI (P=0.14) was found. The positive predictive value (PPV) was 75.9% (60/79) and the negative predictive value (NPV) was 36.5% (19/52) in our study. Escherichia coli (16 cases) had the largest numbers, followed by Klebsiella pneumoniae (8 cases), Staphylococcus aureus (6 cases) and Streptococcus hemolyticus (5 cases). Lungs (16 cases), intestines (11 cases) and wound (7 cases) were the most susceptible organs to infection in the body. Microorganism distribution results showed that Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus and Enterococcus faecium were more active and often infected with multiple organs. These results strengthened our understanding of the postmortem microbial culture in diagnosing infectious diseases when combined with pathological findings.
Keywords: forensic medicine, postmortem blood culture, infectious diseases, cause of death.