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Postmortem angiography using femoral cannulation and postmortem microbiology

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Abstract

Despite the undeniable advantages of postmortem angiography, numerous questions have arisen concerning the influence that the injected contrast media may exercise on biological fluids and tissues collected for toxicological and biochemical investigations. Moreover, cardiac blood for microbiological investigations cannot be obtained post-angiography. In this study, we examined whether the peripheral blood collected prior to postmortem angiography, using percutaneous access to femoral vessels after skin surface disinfection, could be suitable for microbiological investigations when postmortem angiography with femoral vessel cannulation is also performed. A total of 66 cases were included in the study and were divided into two subgroups (angiography and bacteriology group, 33 cases and control group, 33 cases). Autopsies, histology, toxicology, bacteriology, and biochemical investigations (procalcitonin, C-reactive protein, interleukin-6, and soluble triggering receptors expressed on myeloid cells type 1) were performed in all cases. No statistically significant differences between the two groups were noted, and identified category distribution (death unrelated to infection, true infection, false positive, and undetermined) was rather similar in both studied populations. These preliminary results suggest that postmortem angiography using a femoral approach does not constitute an impediment to the collection of peripheral blood for microbiology and vice versa. Moreover, the use of femoral blood for microbiology does not lead to an increased risk of doubtful results.

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References

  1. Palmiere C, Binaghi S, Doenz F, Bize P, Chevallier C, Mangin P, Grabherr S (2012) Detection of hemorrhage source: the diagnostic value of post-mortem CT-angiography. Forensic Sci Int 222:33–39

    Article  CAS  PubMed  Google Scholar 

  2. Grabherr S, Widmer C, Iglesias K, Sporkert F, Augsburger M, Mangin P, Palmiere C (2012) Postmortem biochemistry performed on vitreous humor after postmortem CT-angiography. Leg Med (Tokyo) 14:297–303

    Article  CAS  Google Scholar 

  3. Rutty GN, Smith P, Visser T, Barber J, Amorosa J, Morgan B (2013) The effect on toxicology, biochemistry and immunology investigations by the use of targeted post-mortem computed tomography angiography. Forensic Sci Int 225:42–47

    Article  CAS  PubMed  Google Scholar 

  4. Morris JA, Harrison LM, Partridge SM (2006) Postmortem bacteriology: a re-evaluation. J Clin Pathol 59:1–9

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Weber MA, Hartley JC, Brooke I, Lock PE, Klein NJ, Malone M, Sebire NJ (2010) Post-mortem interval and bacteriological culture yield in sudden unexpected death in infancy (SUDI). Forensic Sci Int 198:121–125

    Article  PubMed  Google Scholar 

  6. Weber MA, Klein NJ, Hartley JC, Lock PE, Malone M, Sebire NJ (2008) Infection and sudden unexpected death in infancy: a systematic retrospective case review. Lancet 371:1848–1853

    Article  CAS  PubMed  Google Scholar 

  7. Morris JA, Harrison LM, Partridge SM (2007) Practical and theoretical aspects of postmortem bacteriology. Curr Diagn Pathol 13:65–74

    Article  Google Scholar 

  8. Tuomisto S, Karhunen PJ, Vuento R, Aittoniemi J, Pessi T (2013) Evaluation of postmortem bacterial migration using culturing and real-time quantitative PCR. J Forensic Sci 58:910–916

    Article  CAS  PubMed  Google Scholar 

  9. Krous HF, Beckwith JB, Byard RW, Rognum TO, Bajanowski T, Corey T, Cutz E, Hanzlick R, Keens TG, Mitchell EA (2004) Sudden infant death syndrome and unclassified sudden infant deaths: a definitional and diagnostic approach. Pediatrics 114:234–238

    Article  PubMed  Google Scholar 

  10. Bajanowski T, Vege A, Byard RW, Krous HF, Arnestad M, Bachs L, Banner J, Blair PS, Borthne A, Dettmeyer R, Fleming P, Gaustad P, Gregersen M, Grøgaard J, Holter E, Isaksen CV, Jorgensen JV, de Lange C, Madea B, Moore I, Morland J, Opdal SH, Råsten-Almqvist P, Schlaud M, Sidebotham P, Skullerud K, Stoltenburg-Didinger G, Stray-Pedersen A, Sveum L, Rognum TO (2007) Sudden infant death syndrome (SIDS)–standardised investigations and classification: recommendations. Forensic Sci Int 165:129–143

    Article  PubMed  Google Scholar 

  11. Lobmaier IV, Vege A, Gaustad P, Rognum TO (2009) Bacteriological investigation—significance of time lapse after death. Eur J Clin Microbiol Infect Dis 28:1191–1198

    Article  CAS  PubMed  Google Scholar 

  12. Zanen-Lim OG, Zanen HC (1980) Postmortem bacteriology of the lung by printculture of frozen tissue. A technique for in situ culture of microorganisms in whole frozen organs. J Clin Pathol 33:474–480

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Tsokos M, Püschel K (2001) Postmortem bacteriology in forensic pathology: diagnostic value and interpretation. Leg Med (Tokyo) 3:15–22

    Article  CAS  Google Scholar 

  14. Grabherr S, Doenz F, Steger B, Dirnhofer R, Dominguez A, Sollberger B, Gygax E, Rizzo E, Chevallier C, Meuli R, Mangin P (2011) Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Legal Med 125:791–802

    Article  PubMed  Google Scholar 

  15. Palmiere C, Bardy D, Mangin P, Augsburger M (2013) Value of sTREM-1, procalcitonin and CRP as laboratory parameters for postmortem diagnosis of sepsis. J Infect 67:545–555

    Article  PubMed  Google Scholar 

  16. Schrag B, Roux-Lombard P, Schneiter D, Vaucher P, Mangin P, Palmiere C (2012) Evaluation of C-reactive protein, procalcitonin, tumor necrosis factor alpha, interleukin-6, and interleukin-8 as diagnostic parameters in sepsis-related fatalities. Int J Legal Med 126:505–512

    Article  PubMed  Google Scholar 

  17. Llewelyn MJ, Berger M, Gregory M, Ramaiah R, Taylor AL, Curdt I, Lajaunias F, Graf R, Blincko SJ, Drage S, Cohen J (2013) Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care. Crit Care 17:R60

    Article  PubMed Central  PubMed  Google Scholar 

  18. Martinez OV, Malinin TI, Valla PH, Flores A (1985) Postmortem bacteriology of cadaver tissue donors: an evaluation of blood cultures as an index of tissue sterility. Diagn Microbiol Infect Dis 3:193–200

    Article  CAS  PubMed  Google Scholar 

  19. Ibrahim T, Stafford H, Esler CN, Power RA (2004) Cadaveric allograft microbiology. Int Orthop 28:315–318

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Varettas K (2013) Micro-organisms isolated from cadaveric samples of allograft musculoskeletal tissue. Cell Tissue Bank 14:621–625

    Article  CAS  PubMed  Google Scholar 

  21. Bettin D, Harms C, Polster J, Niemeyer T (1998) High incidence of pathogenic microorganisms in bone allografts explanted in the morgue. Acta Orthop Scand 69:311–314

    Article  CAS  PubMed  Google Scholar 

  22. Obeng MK, McCauley RL, Barnett JR, Heggers JP, Sheridan K, Schutzler SS (2001) Cadaveric allograft discards as a result of positive skin cultures. Burns 27:267–271

    Article  CAS  PubMed  Google Scholar 

  23. Babb JR, Hall AJ, Marlin R, Ayliffe GA (1989) Bacteriological sampling of postmortem rooms. J Clin Pathol 42:682–688

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Søgaard P, Larsen KE, Buhl L, Lou HE, Henriques U (1991) Bacteriological autopsy. I. A methodological study. APMIS 99:541–544

    Article  PubMed  Google Scholar 

  25. Silver H, Sonnenwirth AC (1969) A practical and efficacious method for obtaining significant postmortem blood cultures. Am J Clin Pathol 52:433–437

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. University Centre of Legal Medicine, University Hospital Center and University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland

    Cristian Palmiere, Coraline Egger & Silke Grabherr

  2. Institute of Microbiology, University Hospital Center and University of Lausanne, Lausanne, Switzerland

    Katia Jaton-Ogay & Gilbert Greub

  3. Service of Infectious Diseases, University Hospital Center, Lausanne, Switzerland

    Gilbert Greub

Authors
  1. Cristian Palmiere
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  2. Coraline Egger
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  3. Silke Grabherr
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  4. Katia Jaton-Ogay
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  5. Gilbert Greub
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Correspondence to Cristian Palmiere.

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Palmiere, C., Egger, C., Grabherr, S. et al. Postmortem angiography using femoral cannulation and postmortem microbiology. Int J Legal Med 129, 861–867 (2015). https://doi.org/10.1007/s00414-014-1099-5

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  • DOI: https://doi.org/10.1007/s00414-014-1099-5

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