Universal neonatal cytomegalovirus screening using saliva - Report of clinical experience

Galia Barkai, Daphne Ari-Even Roth, Asher Barzilai, Michal Tepperberg-Oikawa, Ella Mendelson, Minka Hildesheimer, Jacob Kuint

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)361-366
Number of pages6
JournalJournal of Clinical Virology
Volume60
Issue number4
DOIs
StatePublished - Aug 2014

Keywords

  • Congenital cytomegalovirus
  • Newborn screening
  • Polymerase chain reaction

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Virology

Fingerprint

Dive into the research topics of 'Universal neonatal cytomegalovirus screening using saliva - Report of clinical experience'. Together they form a unique fingerprint.

Cite this