Etiology of Disease and the Practitioner Various Different Microorganisms (Cont’d)

  As embalmers, we must understand that common infections are more often a result of the host interaction of exogenous microorganisms with normal flora within the dead body. After death, the defense mechanisms against microbial interaction ceases. Opportunistic organisms transform from normal flora to facultative anaerobes (capable of anaerobes or aerobic existence).

  There is a time line between life and death where endogenous infections normally occur and when the defensive powers of the body are weakened or the virulence of a disease is increased. Prior to death a health hazard increases for those who handle the body. The problem is that in the majority of deaths whether at a home or in a hospital no one (staff) will divulge the cause of death to the removal care giver. If the death was caused by an infectious disease, it is of utmost importance for the removal personnel to be aware of that fact. This means that written guide lines for proper handling and care of the remains should be established to maintain personal safety and a safe working environment.

  Little is known of the significance of the microbial flora in the human body. A bacterium on exposed surfaces, such as the skin, is not difficult to handle. However, when it is involved with various segments of the gastrointestinal tract, we know little about the interaction between the bacterial species. This interaction leads to a necrotizing effect on tissues thus providing a medium for microorganism growth. This makes cavity treatment both essential and of utmost importance.

  Cavity treatment is one insertion point at the diaphragm to individually treat the thoracic cavity and the abdominal cavity. The diaphragm separates the individual cavities to prevent cross contamination and/or purge. There is evidence of postmortem microbial invasion of tissue with pathogens during the agonal period prior to death. Blood and body fluids from the pleural cavity, bladder, renal pelvis, peritoneal cavity and digestive system show the presence of pathogenic organisms in the issues. They are or could be a potential hazard to the embalmer.

  Hospital acquired infections are a concern for removal personal. Individuals dying following accidents, long term hospitalization or, in some cases, were followed by post-mortem examination could create potential hazards due to procedures used when dealing with indigenous microbiota in various anatomical regions. One of the most common microorganisms in fecal flora is the clostridium perfringens. It is known for growth and production of toxic enzymes and gas whenever trauma or surgery involves the contents of the intestines. This brings about the spread of tissue gas throughout the body. This could create a potential danger to the embalmer and also a disfigurement of the body.

  The release of nosocomial infectious agents involves all major organ systems. They result in bacteremia and are commonly lethal in elderly and depilated individuals. Nosocomial urinary tract infections produce formalin neutralizing ammonia in the tissue. This results in preservation failure of the tissue. Skin and soft tissue infections, such as decubitus ulcers, provide a focal point for growth and multiplying of opportunistic microorganisms. Prior to death, these microbes transmigrate through the vascular network. In death, the body’s normal defense mechanisms cease. Facultative anaerobes or aerobes invade surrounding tissues bringing about decomposition.

  Due to the biochemical reactions in various regions of the body, regional specific preservation treatments are required. Type of treatment is determined by cause of death and time between death and embalming.

  Part 19 will deal with post-embalming treatments and regional anatomical concerns.