Microbiology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Arch Dis Child. 2010 May;95(5):371-6. doi: 10.1136/adc.2009.162792.
To appraise the inter-agency protocol used in sudden unexpected death in infancy (SUDI) cases in South Yorkshire, UK.
A retrospective audit of 121 postmortems carried out over a 3-year period was completed to assess adherence to local guidelines introduced in 2005 specifying the required microbiological specimen set to be collected at postmortem in cases of SUDI. Data on organisms isolated was also collated and assessed for significance.
Sheffield Children's Hospital Histopathology Department is the South Yorkshire referral centre for SUDI. Post-mortem samples were processed by Sheffield Teaching Hospital's microbiology and virology departments.
All postmortems of SUDI in children less than 2 years of age performed between January 2004 and December 2007.
116/121 cases had samples sent for microbiological and/or virological investigation: 90% of cases had a blood culture and 68% had a cerebrospinal fluid sample taken. Of the 116 cases, 49% had a potentially pathogenic organism isolated, 73% had post-mortem flora and 10% had no organisms isolated (32% had both post-mortem flora and a potential pathogen). 27% of cases were found to have middle ear exudate requiring sampling, from 48% of which a potentially pathogenic organism was isolated.
Our finding of a potential pathogen in 57/116 (49%) of our cases, although not necessarily the cause of death, confirms the relevance of performing multisite and virology investigations in all cases of SUDI. Standardised protocols with agreed definitions are necessary for a consistent approach.
评价英国南约克郡婴儿猝死（SUDI）病例中使用的机构间协议。
对 3 年来进行的 121 例尸检进行了回顾性审核，以评估 2005 年引入的当地指南的遵循情况，该指南规定了在 SUDI 病例中进行尸检时需要采集的微生物标本集。还收集和评估了分离出的生物体的数据，并评估了其重要性。
谢菲尔德儿童医院组织病理学系是南约克郡 SUDI 的转诊中心。尸检样本由谢菲尔德教学医院的微生物学和病毒学部门处理。
2004 年 1 月至 2007 年 12 月期间年龄小于 2 岁的所有 SUDI 尸检。
116/121 例病例有样本进行微生物学和/或病毒学检查：90%的病例进行了血液培养，68%的病例进行了脑脊液取样。在 116 例病例中，有 49%分离出潜在病原体，73%有尸检菌群，10%未分离出任何病原体（32%既有尸检菌群又有潜在病原体）。发现 27%的病例有中耳渗出物需要取样，其中 48%分离出潜在病原体。
我们发现 116 例病例中有 57/116（49%）存在潜在病原体，尽管不一定是死亡原因，但证实了对所有 SUDI 病例进行多部位和病毒学检查的相关性。需要标准化协议和商定的定义，以确保一致的方法。
