The Human Body as an Ethanol-Producing Bioreactor—The Forensic Impacts

Abstract

Auto-brewery syndrome (ABS), also called gut fermentation syndrome, is an extremely infrequent but also underrecognized disorder where ethanol is produced endogenously, similar to a typical bioreactor. The reliability of forensic alcohol analysis results is frequently challenged as the ethanol concentration in the breath, blood, and/or urine constitutes important evidence for prosecuting drivers under the influence of the alcohol. This further emphasizes the need to understand ABS, as in legal proceedings it is often presented as grounds for acquittal due to the concept that the findings could have corresponded to endogenously produced ethanol. However, this rare and underdiagnosed medical condition should not be considered as purely a lawyer’s favorite argument. Manifestations of ABS can have a severe impact on a patient’s life and pose social consequences as well. Unfortunately, barely anything has been unearthed, and aspects such as genetic susceptibility, gut-mucus-eating microorganisms, and fecal microbiome transplantation were reviewed for the first time in this context. The framework of this review was not limited to the gut microbiota exclusively; moreover, the overgrowth of microorganisms is linked to the use of antibiotics. Studies have indicated that carbohydrate fermentation occurs in locations other than in intra-intestinal flora. Accordingly, the literature was searched for cases of patients with ABS with yeast infections in their genitourinary or oral systems.

Ethanol and Higher Alcohols’ Production in Fungal and Bacterial Laboratory Cultures and Significance for Forensic Samples

“…The decomposition of a human body post-mortem, viewed through the lens of a cynic, is a rich matrix of organic compounds, crucial for the proliferation of microbes. This system's complexity is underscored by the variability in decomposition processes across different bodies, environmental conditions, and even within various sections of the same cadaver [32,33]. From a biochemical perspective, microbial activity in a deceased body mirrors any system containing substrates favorable to microbial growth under optimal conditions [33].…”

“…This system's complexity is underscored by the variability in decomposition processes across different bodies, environmental conditions, and even within various sections of the same cadaver [32,33]. From a biochemical perspective, microbial activity in a deceased body mirrors any system containing substrates favorable to microbial growth under optimal conditions [33]. From a microbiological point of view, the presence of specific substrates directly influences microbial metabolism, which is further modulated by the intricate interplay of competitive and cooperative interactions among different microbiota species, leading to unpredictable outcomes.…”