Maschmann J, Hamprecht K, Dietz K, Jahn G, Speer C P
Department of Neonatology, University of Tübingen, Germany.
Clin Infect Dis. 2001 Dec 15;33(12):1998-2003. doi: 10.1086/324345. Epub 2001 Nov 12.
In addition to seroprevalence and transmission rate, the clinical symptoms of postnatal cytomegalovirus (CMV) infection in infants with a very low birth weight (VLBW; <1500 g; <32 weeks gestational age at birth) were assessed in a 3-year prospective study. CMV monitoring included serologic testing (of the mother and child) and virus culture and PCR (of samples of both breast milk and the infant's urine). Within 3 weeks of the initial virus detection in the infant, clinical and laboratory parameters were evaluated. Of 170 infants, no CMV transmission was found in the 80 infants of seronegative mothers and in the 3 infants of seropositive mothers who did not shed CMV DNA into breast milk. Transmission occurred in 33 of the 87 CMV-exposed infants, 16 of whom presented with such symptoms as hepatopathy, neutropenia, thrombocytopenia, and sepsis-like deterioration. Low birth weight and early postnatal virus transmission were risk factors for symptomatic infection. VLBW infants of CMV-seropositive mothers are at high risk of acquiring a symptomatic CMV infection postnatally via breast milk.
在一项为期3年的前瞻性研究中，除了评估血清阳性率和传播率外，还对极低出生体重儿（VLBW；出生体重<1500g；出生时胎龄<32周）出生后巨细胞病毒（CMV）感染的临床症状进行了评估。CMV监测包括（母婴的）血清学检测以及（母乳和婴儿尿液样本的）病毒培养和PCR检测。在首次检测到婴儿感染病毒后的3周内，对临床和实验室参数进行了评估。在170名婴儿中，80名血清学阴性母亲的婴儿以及3名血清学阳性但未将CMV DNA排入母乳的母亲的婴儿均未发现CMV传播。87名接触CMV的婴儿中有33名发生了传播，其中16名出现了肝病、中性粒细胞减少、血小板减少和败血症样恶化等症状。低出生体重和出生后早期病毒传播是有症状感染的危险因素。CMV血清学阳性母亲的VLBW婴儿在出生后通过母乳获得有症状CMV感染的风险很高。
