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Title: Postmortem Interval and Diagnostic Performance of the Autopsy Methods
Author: Hurtado, Juan Carlos
Quintó, Llorenç
Castillo, Paola
Carrilho, Carla
Fernandes, Fabiola
Jordao, Dercio
Lovane, Lucilia
Navarro, Mireia
Casas, Isaac
Bene, Rosa
Nhampossa, Tacilta
Santos Ritchie, Paula
Bandeira, Sónia
Sambo, Calvino
Chicamba, Valeria
Mocumbi, Sibone
Jaze, Zara
Mabota, Flora
Ismail, Mamudo R.
Lorenzoni, Cesaltina
Guisseve, Assucena
Rakislova, Natalia
Marimon, Lorena
Castrejon, Natalia
Sanz, Ariadna
Cossa, Anelsio
Mandomando, Inácio
Munguambe, Khátia
Maixenchs, Maria
Muñoz-Almagro, Carmen
Macete, Eusébio
Alonso, Pedro
Vila Estapé, Jordi
Bassat Orellana, Quique
Menéndez, Clara
Martínez Yoldi, Miguel Julián
Ordi i Majà, Jaume
Keywords: Autòpsia
Microbiologia sanitària
Malalties infeccioses
Salut pública
Sanitary microbiology
Communicable diseases
Public health
Issue Date: 31-Oct-2018
Publisher: Nature Publishing Group
Abstract: Postmortem studies, including the complete diagnostic autopsy (CDA) and the minimally invasive autopsy (MIA), an innovative approach to post-mortem sampling and cause of death investigation, are commonly performed within 24 hours after death because the quality of the tissues deteriorates over time. This short timeframe may hamper the feasibility of the procedure. In this study, we compared the diagnostic performance of the two postmortem procedures when carried out earlier and later than 24 hours after death, as well as the impact of increasing postmortem intervals (PMIs) on the results of the microbiological tests in a series of 282 coupled MIA/CDA procedures performed at the Maputo Central Hospital in Mozambique between 2013 and 2015. 214 procedures were conducted within 24 hours of death (early autopsies), and 68 after 24 hours of death (late autopsies). No significant differences were observed in the number of non-conclusive diagnoses (2/214 [1%] vs. 1/68 [1%] p = 0.5645 for the CDA; 27/214 [13%] vs. 5/68 [7%] p = 0.2332 for the MIA). However, increasing PMIs were associated with a raise in the number of bacteria identified (rate: 1.014 per hour [95%CI: 1.002-1.026]; p = 0.0228). This increase was mainly due to rising numbers of bacteria of the Enterobacteriaceae family and Pseudomonas genus strains. Thus, performing MIA or CDA more than 24 hours after death can still render reliable diagnostic results, not only for non-infectious conditions but also for many infectious diseases, although, the contribution of Enterobacteriaceae and Pseudomonas spp. as etiological agents of infections leading to death may be overestimated.
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It is part of: Scientific Reports, 2018, vol. 8, num. 16112
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ISSN: 2045-2322
Appears in Collections:Articles publicats en revistes (Fonaments Clínics)
Articles publicats en revistes (ISGlobal)

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