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Evaluation of post-mortem heart blood culture in a Chinese population
Ren-kuan Tang1, Yun Liu, Yun-zhi Liu
1Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China.
Insights
Post-mortem blood cultures, when analyzed with clinical and pathological data, aid in determining the cause of death. Survival time influences results, but age, gender, and time since death do not significantly impact accuracy.
Area of Science:
- Forensic Pathology
- Medical Microbiology
Background:
- Post-mortem blood cultures are utilized in research but their medico-legal significance remains debated.
- Understanding factors influencing these cultures is crucial for accurate interpretation.
Purpose of the Study:
- To identify factors affecting post-mortem blood culture results.
- To evaluate the utility of these cultures in establishing the cause of death.
Main Methods:
- Retrospective analysis of 76 post-mortem cases with suspected infection.
- Correlation of pathological findings with heart blood culture results.
Main Results:
- Positive heart blood cultures were significantly associated with survival time (P=0.014).
- Age, gender, antibiotic use, and post-mortem intervals did not significantly influence results (P>0.05).
- Positive cultures were observed in 64.5% of cases; common pathogens included E. coli, Streptococcus spp., S. aureus, S. pneumoniae, and Klebsiella spp. Positive predictive value was 77.6%, negative predictive value was 59.3%.
Conclusions:
- Post-mortem heart blood culture results, integrated with clinical and pathological data, enhance the determination of the cause of death.
- These cultures provide valuable etiological information when interpreted cautiously.
Background:
Post-mortem blood cultures have been used in a wide variety of research studies. However, their significance is still a matter of dispute among medico-legal experts. This study was aimed to determine the factors which influenced post-mortem blood culture results and to assess their value in determining the cause of death.
Methods:
We retrospectively investigated 76 post-mortem cases with suspected infection and correlated pathological findings with heart blood culture results.
Results:
We found that survival time after onset of illness was significantly associated with positive heart blood cultures (P=0.014). Blood culture results were not influenced by age, gender, prior antibiotic therapy, interval time from death to store or interval time from death to autopsy (P>0.05). In those who had heart blood cultures taken, 49 cases (64.5%) including four cases with mixed growth, showed positive results, and approximately one-third of blood cultures were sterile. The positive predictive value (PPV) was 77.6% (38/49) including two cases with mixed growth; most were genuine pathogens according to the clinical and pathological findings. However, the negative predictive value (NPV) was 59.3% (16/27). Escherichia coli, Streptococcus spp., Staphylococcus aureus, Streptococcus pneumoniae and Klebsiella spp. were isolated most often.
Conclusion:
These findings suggest that the results of post-mortem heart blood cultures, when combined with clinical and pathological findings, strengthen the understanding of the cause of death.
