Post-mortem microbiology in sudden death: sampling protocols proposed in different clinical settings

Area of Science:

• Forensic Microbiology
• Pathology
• Infectious Diseases

Background:

• Autopsies, including minimally invasive autopsies, are critical for determining cause of death.
• Post-mortem microbiology (PMM) is vital for identifying causative organisms in infections, evaluating treatment, and detecting emergent pathogens.
• The thanatomicrobiome may offer insights into the post-mortem interval.

Purpose of the Study:

• To provide guidance on collecting post-mortem microbiology samples.
• To propose sampling guidelines for microbiologists and autopsy pathologists in sudden death scenarios.

Main Methods:

• A multidisciplinary team of microbiology and autopsy experts contributed to this narrative review.
• Literature search of MedLine and Scopus databases was supplemented with expert knowledge.
• Guidelines were developed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study group of forensic and post-mortem microbiology in collaboration with the European Society of Pathology.

Main Results:

• Guidelines cover preventing contamination in autopsy microbiology.
• Protocols for PMM sampling in various scenarios, including minimally invasive autopsy, are detailed.
• The potential of the post-mortem microbiome for estimating the post-mortem interval is discussed.

Conclusions:

• Adequate sampling is paramount for identifying causative organisms in post-mortem microbiology.
• Interpreting PMM results requires integrating clinical history, macroscopic, and histological findings.
• Enhanced collaboration between microbiologists and autopsy pathologists is crucial for maximizing PMM utility.