The Association of Antimicrobial Therapy with Postmortem Spleen Culture in Bacteremic Patients

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Abstract
A difficulty encountered during antimicrobial clinical trials is to determine whether a patient’s death was related to uncontrolled bacteremia or other factors. Because the postmortem spleen culture correlates with untreated antemortem bacteremia, a study was performed to determine the association of the duration of appropriate antimicrobial therapy with the recovery of the blood culture organism from the postmortem spleen. During the last 10 days of life, blood cultures from 79 patients yielded 85 organisms. The spleen yielded 96%, 55%, 41%, and 35% of the blood culture organisms in patients receiving appropriate antibiotics for 0, less than 2, 2–4, and greater than 4 days, respectively. Statistical analysis with the use of the chi-square test for stratified data showed this to be a significant trend. This correlation suggests that postmortem spleen cultures may be of value in assessing antimicrobial therapy in patients dying within ten days of proven bacteremia.

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