Collados-Ros Aurelia, Pérez-Cárceles María D, Legaz Isabel
Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Faculty of Medicine, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, E-30110 Murcia, Spain.
Life (Basel). 2021 Dec 4;11(12):1345. doi: 10.3390/life11121345.
Sudden unexpected death (SUD) is one of the most important and worthy investigation case profiles in emergency medicine and forensic pathology. Sudden unexpected deaths in adults (SUDA) are frequently caused by cardiac events, while infections usually cause those in infants younger than one year (SUDI), and to a lesser extent, in children older than one year (SUDC). However, in some instances of children under the age of one dying (SIDS), a cause is not discovered despite a thorough investigation that includes a review of clinical history, examination of the death scene, and a complete autopsy. Several studies demonstrate that the microbiome influences host immunity, alters susceptibility to viral respiratory infections, and has a vital role in various health, disease, and death outcomes. The main objective of this systematic review was to compile and offer a complete vision of the main lines of research on microbiome and sudden death that have emerged in recent years and their relationship with forensic sciences, as well as the possible contributions or limitations in the field of forensic sciences.
Following PRISMA principles, a systematic evaluation of the microbiome and sudden death in forensic science was conducted. In this review, our study classified the sudden deaths as SUDA, SUDI, and SIDS.
The role of microbiome research in sudden death is discussed in this review. Various studies have linked the detection of different bacteria or viruses as a probable cause of sudden death. Bacteria analysed differ between studies that used autopsy specimens from deaths classified as SUDA, SUDI, and SIDS, or, except in the case of and , which have been analysed in both SUDI and SIDS autopsies. In the case of viruses, only Cytomegalovirus has been analysed in both SIDS and SUDI cases. However, all the viruses studied are respiratory viruses found in samples of nasopharyngeal or lung fluid.
Although the application of the microbiome in sudden death and other fields of forensic science is still in its early stages, a role of the microbiome in sudden deaths cannot be ruled out, but we cannot conclude that it is a significant factor either.
意外猝死（SUD）是急诊医学和法医病理学中最重要且值得研究的病例类型之一。成人意外猝死（SUDA）通常由心脏事件引起，而感染通常导致一岁以下婴儿的意外猝死（SUDI），在一岁以上儿童的意外猝死（SUDC）中所占比例较小。然而，在一些一岁以下儿童猝死（SIDS）的案例中，尽管进行了全面调查，包括回顾临床病史、检查死亡现场和完整尸检，但仍未发现死因。多项研究表明，微生物群会影响宿主免疫力，改变对病毒性呼吸道感染的易感性，并在各种健康、疾病和死亡结局中发挥重要作用。本系统评价的主要目的是汇总并全面呈现近年来出现的关于微生物群与猝死的主要研究方向及其与法医学的关系，以及法医学领域可能的贡献或局限性。
遵循PRISMA原则，对法医学中微生物群与猝死进行了系统评价。在本评价中，我们的研究将猝死分为SUDA、SUDI和SIDS。
本评价讨论了微生物群研究在猝死中的作用。各种研究将检测到不同的细菌或病毒与猝死的可能原因联系起来。在使用分类为SUDA、SUDI和SIDS的死亡尸检标本的研究中，所分析的细菌有所不同，或者，除了在SUDI和SIDS尸检中均有分析的 和 情况外。就病毒而言，仅在SIDS和SUDI病例中均分析了巨细胞病毒。然而，所有研究的病毒都是在鼻咽或肺液样本中发现的呼吸道病毒。
尽管微生物群在猝死和法医学其他领域的应用仍处于早期阶段，但不能排除微生物群在猝死中发挥作用，但我们也不能得出它是一个重要因素的结论。
