Impact of Non-Uniform Standards in Forensic Postmortem Paediatric Microbiology on the Evidentiary Value of...

To map international literature on the extent, nature and standards of evidence on postmortem microbiology (PMM) sampling in paediatric cases. Investigations of sudden unexpected deaths in infancy and childhood warrant high standards due to their public health and legal significance. PMM is an integral component of these investigations. The review aimed to examine paediatric studies; however, only a single study was identified. The review therefore included articles on PMM of all ages and forensic and clinical autopsies. Data sources used were Medline, Embase, Cochrane CENTRAL and Scopus. Primary studies were selected by title and abstract screening using Covidence. Twenty four primary studies covering 2965 postmortems with an age range of 0-90+ years. There was significant heterogeneity in the selection of sampling sites and interpretation, with no consistent definition for contamination or true infection. There were significant gaps in literature, particularly the lack of paediatric studies, standardised techniques for specimen collection and definition of contamination. An interpretation framework for PMM results was proposed by the authors. These gaps warrant immediate attention as inconsistent interpretation of PMM results can lead to low public confidence in mortality statistics, disease surveillance data and public health policy.