Abstract
Death due to respiratory infection is commonly encountered at autopsy. With only one opportunity to obtain samples for identification of a causative agent, it is important to ensure that sampling regimes are optimized to provide the greatest detection, without the expense and redundancy that can arise from over-sampling. This study was performed retrospectively using data from Coronial autopsies over the period 2012–2019 from which swabs from the nasopharyngeal region, trachea and lung parenchyma, in addition to samples of lung tissue, had been submitted for multiplex PCR detection of respiratory pathogens. From 97 cases with all four samples, there were 24 with at least one positive result for viral infection. Some cases had multiple positive results and a total of 27 respiratory tract viruses were identified, of which rhinovirus, influenza A virus and respiratory syncytial virus were the most common. Seventeen of the 27 viral infections (63%) were identified in all four samples. However, in nearly all cases (96%) the nasopharyngeal swab detected the infective agent when the multiplex PCR panel had detected infection in any of the four sample types. A nasopharyngeal swab is considered to be an optimal sample for detection of respiratory tract viral infection. As the samples analyzed were acquired before the appearance of the COVID-19 virus, the applicability of this finding for COVID-19 screening is not established.
Highlights
Lower respiratory tract infections are the third largest cause of death globally, so it is unsurprising that deaths following suspected respiratory infections are often referred to the Coroner [1]
We found 94 cases that had been autopsied between June 2012 and June 2019 from which four respiratory samples had been obtained for testing by multiplex PCR panel
As the respiratory tract is a common site of infection, it is an important component of the post-mortem examination to be able to accurately detect the causative microorganisms [1]
Summary
Lower respiratory tract infections are the third largest cause of death globally, so it is unsurprising that deaths following suspected respiratory infections are often referred to the Coroner [1] In such cases, microbiological investigations can allow determination of the responsible organisms. Without guidelines to inform best practice for detection of respiratory tract infection, multiple swabs may be taken alongside lung tissue to minimize the risk of missing infection. This can equate to both a high cost for the investigating institution, and increased workload for pathology centers. This study sought to explore the practice of sampling for detecting respiratory tract viral infection with the intention to find an optimal sample
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
