Particularities Regarding the Etiology of Sepsis in Forensic Services

Dermengiu, Dan; Curcă, George Cristian; Ceauşu, Mihai; Hostiuc, Sorin

doi:10.1111/1556-4029.12222

Cited by 13 publications

(27 citation statements)

References 21 publications

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“…Testing in one case, classified as viral pneumonia COD, did not yield any positive viral findings. However the histological findings were consistent with viral pneumonia (interstitial pneumonitis), and the person had been treated with antiviral antibiotics before death which could cause the negative viral findings [7]. CRP was measured in 33 cases.…”

Section: Resultsmentioning

confidence: 99%

“…Tuomisto et al [8] suggest liver and pericardial sampling as the most reliable within the first five days after death. Preferably, cultures should be verified by gross pathologic or histologic findings [7,9].…”

Section: Discussionmentioning

confidence: 99%

“…When bacteria are cultured postmortem, one must consider several mechanisms which could lead to bacteria in the samples. Four lines of spread have been suggested [7,12].…”

Section: Discussionmentioning

confidence: 99%

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The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

Christoffersen

2015

Forensic Science International

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Microorganisms have always been one of the great challenges of humankind, being responsible for both high morbidity and mortality throughout history. In a forensic setting microbiological information will always be difficult to interpret due to lack of antemortem information and changes in flora postmortem. With this study we aim to review the use of microbiological procedures at our forensic institute. In a retrospective study including 42 autopsies performed at our Institute, where microbiological test had been applied, analyses were made with regard to: type of microbiological tests performed, microorganisms found, histological findings, antemortem information, C-reactive protein measurement and cause of death. Fiftyone different microorganisms were found distributed among 37 cases, bacteria being the most abundant. Nineteen of the cases were classified as having a microbiological related cause of death. C-reactive protein levels were raised in 14 cases of the 19 cases, histological findings either supported or were a decisive factor for the classification of microbiologically related cause of death in 14 cases. As a multitude of abundant microorganisms are able to cause infection under the right circumstances, all findings should be compared to anamnestic antemortem information, before conclusions are drawn. A definite list of true pathogens is nearly impossible to compile.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

Christoffersen

2015

Forensic Science International

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“…P. aeruginosa is a common cause of opportunistic infection in hospitalized patients and is known to chronically colonize patients with structural lung diseases, such as cystic fibrosis, bronchiectasis, and chronic obstructive pulmonary disease (COPD), as opposed to nonstructural lung diseases, such as pulmonary edema, chronic thrombotic disease, or atelectasis (3,4). Acute lower respiratory tract infections caused by P. aeruginosa can lead to severe complications, such as acute respiratory distress syndrome (ARDS) and sepsis (5,6). The clinical outcomes associated with P. aeruginosa pneumonia are the product of the immune system's ability to recognize and clear pathogenic organisms, known as host resistance (7)(8)(9).…”

mentioning

confidence: 99%

Chitinase 3-Like 1 (Chil1) Regulates Survival and Macrophage-Mediated Interleukin-1β and Tumor Necrosis Factor Alpha during Pseudomonas aeruginosa Pneumonia

et al. 2016

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dPseudomonas aeruginosa causes hospital-acquired pneumonia and is associated with high mortality. An effective response to such an infection includes efficient clearance of pathogenic organisms while limiting collateral damage from the host inflammatory response, known as host resistance and host tolerance, respectively. P. aeruginosa expresses a type III secretion system (T3SS) needle complex that induces NLRC4 (NOD-like receptor C4) activation, interleukin-1␤ (IL-1␤) production, and host tissue damage. Chitinase 3-like-1 (Chil1) is expressed during infection and binds to its receptor, IL-13 receptor ␣2 (IL-13R␣2), to regulate the pathogen-host response during Streptococcus pneumoniae infection, but the role Chil1 plays in balancing the host resistance and host tolerance during P. aeruginosa pneumonia is not known. We conducted experiments using C57BL/6 mice with or without a genetic deficiency of Chil1 and demonstrated that Chil1-deficient mice succumb to P. aeruginosa infection more rapidly than the wild type (WT). The decreased survival time in infected Chil1-deficient mice is associated with more neutrophils recruited to the airways, more lung parenchymal damage, and increased pulmonary consolidation while maintaining equivalent bacterial killing compared to WT mice. Infected Chil1-deficient mice and bone marrow-derived macrophages (BMDMs) from Chil1-deficient mice have increased production of tumor necrosis factor alpha (TNF-␣) and IL-1␤ compared to infected WT mice and macrophages. Infection of Chil1-deficient BMDMs with non-NLRC4-triggering P. aeruginosa, which is deficient in the T3SS needle complex, did not alter the excessive IL-1␤ production compared to BMDMs from WT mice. The addition of recombinant Chil1 decreases the excessive IL-1␤ production but only partially rescues stimulated BMDMs from IL-13R␣2-deficient mice. Our data provide mechanistic insights into how Chil1 regulates P. aeruginosa-induced host responses. Hospital-acquired pneumonia is a common cause of hospitalassociated death and morbidity (1, 2). Pseudomonas aeruginosa causes both acute and chronic respiratory infections. P. aeruginosa is a common cause of opportunistic infection in hospitalized patients and is known to chronically colonize patients with structural lung diseases, such as cystic fibrosis, bronchiectasis, and chronic obstructive pulmonary disease (COPD), as opposed to nonstructural lung diseases, such as pulmonary edema, chronic thrombotic disease, or atelectasis (3, 4). Acute lower respiratory tract infections caused by P. aeruginosa can lead to severe complications, such as acute respiratory distress syndrome (ARDS) and sepsis (5, 6). The clinical outcomes associated with P. aeruginosa pneumonia are the product of the immune system's ability to recognize and clear pathogenic organisms, known as host resistance (7-9). Recent investigations have led to a better appreciation that the pathogen-mediated immune response also causes collateral damage to host tissues independently of the bacterial burden, which also can contr...

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“…However, the concentrations of these parameters can be increased due to etiologies other than bacterial infections. Hence, as in the clinical field, in recent years other laboratory parameters have been investigated in order to define the most suitable biomarker (or combination of biomarkers) that might more effectively discriminate non-infectious from infectious inflammations (9-15). …”

mentioning

confidence: 99%

Markers for sepsis diagnosis in the forensic setting: state of the art

Palmière¹,

Augsburger²

2014

Croat Med J

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Reliable diagnoses of sepsis remain challenging in forensic pathology routine despite improved methods of sample collection and extensive biochemical and immunohistochemical investigations. Macroscopic findings may be elusive and have an infectious or non-infectious origin. Blood culture results can be difficult to interpret due to postmortem contamination or bacterial translocation. Lastly, peripheral and cardiac blood may be unavailable during autopsy. Procalcitonin, C-reactive protein, and interleukin-6 can be measured in biological fluids collected during autopsy and may be used as in clinical practice for diagnostic purposes. However, concentrations of these parameters may be increased due to etiologies other than bacterial infections, indicating that a combination of biomarkers could more effectively discriminate non-infectious from infectious inflammations. In this article, we propose a review of the literature pertaining to the diagnostic performance of classical and novel biomarkers of inflammation and bacterial infection in the forensic setting.

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Particularities Regarding the Etiology of Sepsis in Forensic Services

Cited by 13 publications

References 21 publications

The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

The importance of microbiological testing for establishing cause of death in 42 forensic autopsies

Chitinase 3-Like 1 (Chil1) Regulates Survival and Macrophage-Mediated Interleukin-1β and Tumor Necrosis Factor Alpha during Pseudomonas aeruginosa Pneumonia

Markers for sepsis diagnosis in the forensic setting: state of the art

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