ROUTINE MICROBIOLOGICAL TESTING IN SUDDEN AND UNEXPECTED INFANT DEATH

Objective: To evaluate the significance of microbiological test result s in a series of infants who had died suddenly and unexpectedly. Metho dology: Following a review of all cases of sudden natural death in inf ants presenting to the Adelaide Children's Hospital (AGH) division of the Women's and Children's Hospital (WCH) over the 10 year period betw een 1983 and 1992, specific evaluation of microbiological test results was undertaken. Results: There were 329 cases of sudden infant death syndrome (SIDS) and 23 cases in which sudden infant death was either a ttributed to other conditions or was unclassifiable. Positive microbio logical results were recorded in the majority of cases, most being con sidered to be due to postmortem overgrowth or to contamination at auto psy. Of the remaining cases, microbiological results were essential to the establishment of the diagnosis in three cases, and were a useful adjunct to the diagnosis in a further six cases. Conclusions: Routine microbiological testing in cases presenting as SIDS did not reveal occ ult sepsis in most instances. Such testing did, however, add support t o the diagnosis of SIDS where no pathogens were isolated and, if not u ndertaken, would have resulted in a small percentage of cases of sudde n infant death due to infections remaining undiagnosed.