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Diagnostic utility of postmortem blood cultures
S J Wilson1, M L Wilson, L B Reller
1Clinical Microbiology Laboratory, Duke University School of Medicine, Durham, NC.
Archives of Pathology & Laboratory Medicine
|October 1, 1993
Summary
Postmortem blood cultures rarely offer new diagnostic information beyond antemortem tests. This study found they often yield contaminants or inconclusive results, questioning their utility in autopsy quality assurance.
Area of Science:
- Medical Diagnostics
- Pathology
- Infectious Disease
Background:
- Autopsies are increasingly used for clinical quality assurance.
- Postmortem blood cultures are common autopsy procedures but their diagnostic value is debated.
- The cost-effectiveness and utility of postmortem blood cultures require assessment.
Purpose of the Study:
- To evaluate the diagnostic utility of postmortem blood cultures.
- To determine if postmortem blood cultures provide information not available from antemortem cultures.
- To assess the contribution of postmortem blood cultures to autopsy quality assurance.
Main Methods:
- Comparison of 111 postmortem blood cultures with antemortem blood culture results.
- Analysis of positive postmortem cultures in relation to cause of death and antemortem findings.
- Assessment of microbial yield from postmortem cultures for diagnostic significance.
Main Results:
- 54% of postmortem blood cultures were positive, often unrelated to the cause of death.
- Of patients with antemortem bacteremia/fungemia, postmortem cultures frequently yielded contaminants or different organisms.
- Postmortem cultures rarely provided new, interpretable, or useful information compared to antemortem data and clinical findings.
Conclusions:
- Postmortem blood cultures seldom yield clinically significant information beyond antemortem data.
- The diagnostic utility of postmortem blood cultures in autopsy quality assurance is questionable.
- Routine postmortem blood cultures may not be cost-effective or diagnostically valuable.