Incidence of congenital cytomegalovirus infection in Ireland: Implications for screening and diagnosis |
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| Affiliation: | 1. National Virus Reference Laboratory (NVRL), University College Dublin, Belfield, Dublin 4, Ireland;2. National Maternity Hospital (NMH), Holles Street, Dublin 2, Ireland;3. Frimley Park Hospital, Surrey, United Kingdom;1. Department of Neonatology, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands;2. Department of Pediatric Infectious Diseases, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands;3. Department of Medical Microbiology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands;1. Janssen Research & Development LLC, Titusville, NJ, USA;2. Janssen Infectious Diseases BVBA, Beerse, Belgium;3. Vertex Pharmaceuticals Incorporated, Cambridge, MA, USA;4. Transgene SA, Cambridge, MA, USA;5. Johann Wolfgang Goethe University Medical Center, Frankfurt am Main, Germany;1. Ghent University, Faculty of Medicine and Health Sciences, Belgium;2. Ghent University Hospital, ENT-Department, De Pintelaan 185, 1P1, 9000 Ghent, Belgium;1. Neonatology, The Edmond and Lily Safra Children''s Hospital, Chaim Sheba Medical Center, Israel;2. Pediatric Infectious Disease Unit, The Edmond and Lily Safra Children''s Hospital, Chaim Sheba Medical Center, Israel;3. Hearing, Speech and Language Center, Chaim Sheba Medical Center, Israel;4. Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Israel;5. Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Israel;6. Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Israel;7. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel |
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| Abstract: | BackgroundCongenital cytomegalovirus (cCMV) causes serious intrauterine infection and is the leading cause of sensorineural hearing loss. In the absence of routine screening, asymptomatic infections, which constitute approximately 90% of all cCMV cases, remain undiagnosed; however many clinical abnormalities manifest later in childhood.ObjectivesThe aims of the present study were to determine, for the first time, the incidence of cCMV infection in a large maternity hospital in Dublin city and the optimal sampling method for neonatal screening.Study designA pilot screening study of asymptomatic infants born was conducted over a 12-month period. Mothers were consented and neonates screened for evidence of CMV infection (n = 1044). Urine or saliva was tested for the presence of CMV DNA and reactive results were confirmed with follow-up testing and clinical evaluation.ResultscCMV incidence in the asymptomatic neonates screened was 0.19%. An overall cCMV incidence was extrapolated based on the total number of live-births and data from those infants routinely screened for cCMV during the study period, and estimated as 0.23%. Neonatal urine collection proved prohibitive to mass screening. However, testing of saliva for CMV DNA was rapid, sensitive and suitable for screening. Furthermore, in a low prevalence population, pooling of patient samples proved effective and cost-efficient.ConclusionsThe present study concluded that there is a significant burden of undiagnosed cCMV infection in Ireland. The introduction of neonatal CMV DNA testing of saliva is viable, and could be considered as part of the national newborn screening programme, following a cost-benefit analysis. |
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| Keywords: | Congenital Cytomegalovirus Incidence Newborn screening Ireland |
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