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Diagn Microbiol Infect Dis. 2016 Jan;84(1):80-86. doi: 10.1016/j.diagmicrobio.2015.10.002. Epub 2015 Oct 9.

Infectious cause of death determination using minimally invasive autopsies in developing countries.

Author information

1
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic, Universitat de Barcelona, Spain. Electronic address: myoldi@clinic.ub.es.
2
Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
3
Department of Pathology, Maputo Central Hospital, Maputo, Mozambique.
4
Department of Molecular Microbiology, University Hospital Sant Joan de Deu, Barcelona, Spain.
5
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
6
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
7
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Clinical Microbiology, Hospital Clinic, Universitat de Barcelona, Spain.
8
Department of Clinical Microbiology, Hospital Clinic, Universitat de Barcelona, Spain.
9
Fundação de Medicina Tropical Dr. Heitor Viera Dourado, Manaus, Amazonas, Brazil.
10
ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Pathology, Hospital Clinic, Universitat de Barcelona, Spain.

Abstract

In developing countries, the knowledge of the microorganisms causing fatal infections is critical and could help designing and implementing more effective preventive interventions and treatment guidelines. We aimed to develop and validate protocols for microbiological analysis in post-mortem samples obtained during minimally invasive autopsy (MIA) procedures and to assess their performance. Thirty MIAs performed in adults at Maputo Central Hospital in Southern Mozambique were included in the analysis. Microbiological tests included a universal screening for HIV, hepatitis B and C viruses, Plasmodium falciparum, and bacterial/fungal culture. In addition, a variety of molecular microbiology assays guided by the histological results were performed in blood, cerebrospinal fluid and a variety of tissue samples including liver, lung and central nervous system. The combination of culture-based methods together with molecular microbiological assays led to the identification of 17 out of 19 (89.5%) of the infectious deaths. Microorganisms identified included Mycobacterium tuberculosis, Toxoplasma gondii, Pneumocystis jiroveci, Cryptococcus neoformans, hepatitis B virus, human herpesvirus 8, cytomegalovirus, Streptococcus pneumoniae, Streptococcus dysgalactiae, Ryzopus oryzae, and Acinetobacter baumannii. The combination of classical cultures, serological tests and molecular assays performed in samples obtained through MIA allows the identification of most infectious agents causing death.

KEYWORDS:

Microbiological studies; Minimally invasive autopsy

[Indexed for MEDLINE]

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