传染病的死后传播风险:系统综述。

IF 1.3 4区 医学 Q3 MEDICINE, LEGAL Legal Medicine Pub Date : 2024-09-23 DOI:10.1016/j.legalmed.2024.102530
L. Geoffray , L. Tuchtan , M-D. Piercecchi-Marti , C. Delteil
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引用次数: 0

摘要

介绍:尸体解剖可能面临传染风险。本研究的目的是评估工作场所死后传播 HIV、HBV、HCV、结核分枝杆菌(MBT)、SARS-CoV2 和朊病毒的风险,并估计其传染性的持续时间。对 Pubmed、Web of Science、Google Scholar 和 Sciencedirect 数据库进行了评估,直至 2023 年 2 月 28 日。我们搜索了任何语言、任何出版日期的文章。涉及动物、两个活人之间传播或工作场所以外传播的研究均被排除在外。针对每种类型的研究,我们使用适当的评估工具对偏倚风险进行了评估。对结果进行了描述性分析:共纳入 46 项研究。确定了艾滋病毒(1 例)和甲基溴(18 例)的死后传播病例。艾滋病毒、乙型肝炎病毒和丙型肝炎病毒的死后诊断检测呈阳性的最长间隔时间分别为 17 天、60 天、7 天、36 天和 17 天。艾滋病毒培养呈阳性的最长尸检间隔时间为 21 小时,乙型肝炎病毒为 6 天,甲基溴检测为 36 天,SARS-CoV2 为 17 天。这些研究的方法不尽相同,其中一些研究存在较高的偏倚风险:结论:文献中缺乏有关尸体感染性的一致数据,甲基溴灭菌法除外。立法似乎以尽量减少生物制剂与专业人员的接触为基础。在缺乏最新可靠科学数据的情况下,工作人员应系统地遵循最佳做法建议。
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Post-mortem transmission risk of infectious disease: A systematic review

Introduction

Autopsies may expose to infectious risks. The objective of this study is to assess the risk of post-mortem transmission of HIV, HBV, HCV, Mycobacterium tuberculosis (MBT), SARS-CoV2 and prion in the workplace and to estimate the duration of their infectiousness.

Material and method

the PRISMA 2020 guideline was used. Pubmed, Web of Science, Google Scholar and Sciencedirect databases were assessed until February 28, 2023. We searched for articles in any language and any date of publication. Studies involving animals, transmission between two living people or transmission outside the workplace were excluded. Risk of bias was assessed using the appropriate assessment tools for each type of study. A descriptive analysis was performed.

Results

A total of 46 studies were included. Cases of post-mortem transmission were certain for HIV (n = 1) and MBT (n = 18). The longest post-mortem interval for positive diagnostic tests was 17 days for HIV, 60 for HBV, 7 for HCV, 36 for MBT and 17 for SARS-CoV2. The longest post-mortem interval for positive cultures was 21 h for HIV, 6 days for HBV, 36 days for MBT, 17 days for SARS-CoV2. The methodology of the studies was heterogeneous, some of them associated with a high risk of bias.

Conclusion

There is a lack of consistent data in the literature concerning the infectivity of cadavers, except for MBT. Legislation appears to be based on minimizing contact between the biological agent and the professional. In the absence of recent robust scientific data, workers should systematically follow the best practice recommendations.
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来源期刊
Legal Medicine
Legal Medicine Nursing-Issues, Ethics and Legal Aspects
CiteScore
2.80
自引率
6.70%
发文量
119
审稿时长
7.9 weeks
期刊介绍: Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.
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