High-throughput 16S rDNA sequencing assisting in the detection of bacterial pathogen candidates: a fatal case of necroti
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CASE REPORT
High-throughput 16S rDNA sequencing assisting in the detection of bacterial pathogen candidates: a fatal case of necrotizing fasciitis in a child Dong Qu 1,2 & Dong-Fang Qiao 1 & Michael Klintschar 2 & Zhi Qu 3 & Xia Yue 1 Received: 24 July 2020 / Accepted: 2 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Postmortem detection of pathogens in infectious deaths is quite important for diagnosing the cause of death and public health. However, it is difficult to detect possible bacterial pathogens in forensic practice using conventional methods like bacterial culture, especially in cases with putrefaction and antibiotic treatment. We report a fatal case caused by necrotizing fasciitis due to bacterial infection. An 8-year-old girl was found dead during sleep 4 days after a minor trauma to her left knee. The gross autopsy suggested that bacterial soft tissue infection might be the cause of death, and the microscopic examination confirmed the diagnosis. The slight putrefaction found at gross autopsy might interfere through postmortem bacterial translocation and reproduction with bacterial culture. High-throughput 16S rDNA sequencing was employed to identify possible pathogens. Bacterial DNA sequencing results suggested Streptococcus pyogenes and Staphylococcus, typical pathogens of necrotizing fasciitis in the tissue. 16S rDNA sequencing might thus be a useful tool for accurate detection of pathogens in forensic practice. Keywords Forensic medicine . Infectious death . Pathogen detection . 16S rDNA sequencing . Necrotizing fasciitis
Introduction Identification of pathogens in infectious death plays a vital role in determining the cause of death and assists in reporting infectious deaths to public health authorities. In forensic practice, most of the infectious deaths are diagnosed without antemortem identification of pathogens, especially in cases without medical intervention. So far now, the conventional methods of diagnosing pathogens in clinical practice are real-time PCR (RT-PCR) for virus detection and bacterial culture for bacterial detection [1, 2]. These two methods are also applied in most of the infectious death cases. However, it is difficult to detect bacterial pathogens using bacterial culture in * Xia Yue [email protected] 1
Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou 510515, China
2
Institute of Legal Medicine, Hannover Medical School, 30625 Hannover, Germany
3
Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, 30625 Hannover, Germany
some special situations. Slight or moderate putrefaction is quite common in forensic autopsies, and putrefaction would interfere with the detection of pathogens, on account of the postmortem bacterial translocation and reproduction [3]. As we know, diagnosing of fastidious or rare bacteria is difficult using conventional bacterial testing methods in clinical practice [2, 4], even more so in post-mortem samples wi
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