Sudden unexpected death in infancy: evidence of infection.

摘要

In today's Lancet, Martin Weber and colleagues8 show ; just how useful postmortem bacteriology can be. The researchers present bacteriological results for 507 cases of SUDI. Collected over 10 years, the series includes 379 cases of unexplained SUDI, 72 cases of explained SUDI with a non-infective cause, and 56 cases of explained SUDI caused by infection diagnosed on the basis of histology. Deaths caused by infection were in slightly older children than those in the othertwo groups; but the age distributions of the unexplained SUDI group and the explained non-infection group were the same. This is important because bacterial mucosal carriage is strongly age-dependent. The bacterial isolates were classified into three groups: non-pathogens; group 1 pathogens, which are organisms usually associated with a recognisable focus of infection; and group 2 pathogens, which are organisms known to cause septicaemia without an obvious focus. Group 2 pathogens were more common in the explained SUDI infection group and the unexplained SUDI group than in the explained SUDI non-infection group. In particular, S aureus and E coli were more commonly found in the unexplained SUDI group than in cases of non-infective explained SUDI.