Post-mortem detection of bacteremia using pairs of blood culture samples.

Abstract

The objective of this study was to assess the utility of examining pairs of blood culture samples obtained from separate sites (both ventricles or the aorta and vena cava) for detecting bacteremia in the post-mortem setting. Autopsy cases in which bacterial species were isolated from blood cultures were identified over a 4-year period. Ante-mortem and post-mortem records and the findings of pathological examinations were reviewed. Overall, 23 bacterial species were detected in 18 autopsy cases. E. coli was the most commonly detected species (5 cases, 27.8%), followed by S. aureus and K. pneumoniae, respectively. Seven of the detected bacterial species (3 cases, 16.7%) were obligate anaerobes (Clostridium spp. and Bacteroides spp.). Among the 3 cases involving obligate anaerobes, multiple bacterial species were detected in 2 cases. Clinically, 2 of the 18 patients in which bacteria were detected were treated for significant infections (urosepsis, pneumonia, and catheter-related bloodstream infection) before their deaths. Seven cases exhibited evidence of significant infection during the post-mortem pathological examination. The differences between the aerobic and anaerobic bacteria positivity rates of the single and paired blood culture samples were significant (aerobic: p=0.013 and anaerobic: p=0.018). Analyzing pairs of blood culture samples obtained from separate sites is useful for detecting bacteremia during post-mortem examinations.