TY - JOUR
T1 - Universal neonatal cytomegalovirus screening using saliva - Report of clinical experience
AU - Barkai, Galia
AU - Ari-Even Roth, Daphne
AU - Barzilai, Asher
AU - Tepperberg-Oikawa, Michal
AU - Mendelson, Ella
AU - Hildesheimer, Minka
AU - Kuint, Jacob
N1 - Funding Information: Upon approval of the Medical Center General Manager, a project of newborn screening for CMV was launched. Beginning 15/5/2011, saliva was collected immediately after birth from all infants born at the Chaim Sheba Medical Center. On admittance to the labor and delivery room, parents were notified of the screening and were given the option to object (informed dissent). Approval of the local ethics committee was obtained for retrospective analysis of data collected from infants born during the period 15/5/2011–15/5/2012. Funding was provided through an internal hospital grant reserved for clinical projects.
PY - 2014/8
Y1 - 2014/8
N2 - Objectives: To analyze the results of a neonatal universal screen for congenital cytomegalovirus (CMV) using saliva real-time polymerase chain reaction (rt-PCR). Study design: During one year (15/5/2011-15/5/2012), saliva was collected from 9845 infants (97% of 10,137 newborns). Viral DNA was extracted by Magna-Pure LC (Roche) and was tested for the presence of CMV IE and gB genes. Urine culture was collected from positive infants for confirmation. For all infants with congenital CMV maternal data were collected and head ultrasound, blood count, liver enzymes, retinal examination and auditory brainstem response testing were performed. Parents were notified in advance and had the option to avoid screening. The ethical committee approved retrospective analysis of the data. Results: Fifty six infants (0.57%) had a positive saliva assay. Of these, 47 were confirmed by urine rt-PCR and culture, in another one maternal sero-conversion was documented during pregnancy (48 infants). Twenty-eight mothers (28/47, 60%) had primary infection during pregnancy, 14 (30%) had non-primary infection, and no serological data were obtained from five (10%). Four infants (8.5%), two with prenatal diagnosis of CMV and normal fetal brain imaging and two born to mothers sero-positive before pregnancy, exhibited symptoms related to CMV and were offered antivirals. Hearing impairment was diagnosed in two infants (late onset HI in one case). Conclusions: Saliva rt-PCR assay is a feasible and effective means of universal neonatal CMV screening that can detect affected infants who might benefit from treatment and follow-up. The long-term clinical significance of screening and its cost effectiveness are yet to be determined.
AB - Objectives: To analyze the results of a neonatal universal screen for congenital cytomegalovirus (CMV) using saliva real-time polymerase chain reaction (rt-PCR). Study design: During one year (15/5/2011-15/5/2012), saliva was collected from 9845 infants (97% of 10,137 newborns). Viral DNA was extracted by Magna-Pure LC (Roche) and was tested for the presence of CMV IE and gB genes. Urine culture was collected from positive infants for confirmation. For all infants with congenital CMV maternal data were collected and head ultrasound, blood count, liver enzymes, retinal examination and auditory brainstem response testing were performed. Parents were notified in advance and had the option to avoid screening. The ethical committee approved retrospective analysis of the data. Results: Fifty six infants (0.57%) had a positive saliva assay. Of these, 47 were confirmed by urine rt-PCR and culture, in another one maternal sero-conversion was documented during pregnancy (48 infants). Twenty-eight mothers (28/47, 60%) had primary infection during pregnancy, 14 (30%) had non-primary infection, and no serological data were obtained from five (10%). Four infants (8.5%), two with prenatal diagnosis of CMV and normal fetal brain imaging and two born to mothers sero-positive before pregnancy, exhibited symptoms related to CMV and were offered antivirals. Hearing impairment was diagnosed in two infants (late onset HI in one case). Conclusions: Saliva rt-PCR assay is a feasible and effective means of universal neonatal CMV screening that can detect affected infants who might benefit from treatment and follow-up. The long-term clinical significance of screening and its cost effectiveness are yet to be determined.
KW - Congenital cytomegalovirus
KW - Newborn screening
KW - Polymerase chain reaction
UR - http://www.scopus.com/inward/record.url?scp=84903593989&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jcv.2014.04.024
DO - https://doi.org/10.1016/j.jcv.2014.04.024
M3 - مقالة
C2 - 24881490
SN - 1386-6532
VL - 60
SP - 361
EP - 366
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
IS - 4
ER -