Anaerobic bacteria in postmortem blood cultures

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POSTMORTEM bacteriology has attracted little attention in the literature over the years, and it is an aspect that is one of the most neglected in the specialty of pathology in many institutions. In American and Canadian publications since 1915 we have found only 15 reports1–15 pertaining specifically to autopsy microbiology. Only one16 of the current textbooks on microbiology mentions the subject to any great extent. There are several reasons for this lack of attention: the once popular concept of postmortem invasion of the bloodstream by bacteria that populate the gastrointestinal tract;17 the difficulty of obtaining, at the autopsy table, uncontaminated material for cultures; the fact that tissue is difficult to work with in the microbiology laboratory; and lastly, the difficulties involved in the interpretation of postmortem microbiological studies.

The purpose of this report is to present the results of a study of 237 patients which shows correlation of: symptoms immediately preceding death, postmortem finding of gastrointestinal lesions, and postmortem blood cultures.

Materials and methods

A postmortem blood culture is obtained when feasible, via a right atrial puncture. This is performed by exposing and elevating the heart, drying the immediate area of the heart as well as possible, and sterilizing the juncture of the inferior vena cava and the right atrium by searing with a hot thin spatula. The seared area of the right atrium is then punctured with a sterile needle with attached syringe; approximately 5 ml of blood is obtained, and immediately placed into 30 ml of fresh thioglycollate . . .



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