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在母亲血清学阳性背景下对墨西哥早产儿巨细胞病毒的检测及糖蛋白B基因分型

Detection and gB genotyping of CMV in Mexican preterm infants in the context of maternal seropositivity.

作者信息

Arellano-Galindo José, Villanueva-García Dina, Cruz-Ramirez José Luis, Yalaupari-Mejìa Juan Pablo, Uribe-Gutiérrez Gabriel, Velazquez-Guadarrama Norma, Nava-Frias Margarita, Munoz-Hernández Onofre, Mejía-Arangure Juan Manuel

机构信息

Hospital Infantil de México Federico Gómez Dr. Márquez, México D.F., Mexico.

出版信息

J Infect Dev Ctries. 2014 Jun 11;8(6):758-67. doi: 10.3855/jidc.3501.

Abstract

INTRODUCTION

Congenital (CI) and perinatal cytomegalovirus (CMV) infections (PI) can be linked to maternal CMV seropositivity, with fatal consequences in preterm newborns. GB genotyping has been used to analyze genotypic similarity in mothers and infants. The frequency of CMV infection in the context of maternal seropositivity and the viral gB genotypes as well as the genotypic similarity in mothers and preterm infants were investigated.

METHODOLOGY

Saliva samples and dry blood spots (DBS) were taken weekly from preterm newborns  from birth until the first month of life, and breast milk samples were taken from their mothers weekly during the first month of lactation. CMV IgG seroprevalence of the mothers and CI or PI in the infants were established. The gB status and genotypic similarities were established retrospectively in DBS and in the breast milk samples.

RESULTS

In total, 387 neonates and 375 mothers were enrolled. The maternal CMV-positive IgG serology was 97.3% (365/375). Neonatal CMV was found in 5.1% (20/387) of newborns, and one infant presented with CMV-compatible symptoms. CI was 2.5% and PI in the first month after birth was 11.8%. GB2 was the most prevalent genotype and was also the genotype preferentially transmitted to newborns by mothers with mixed infections.

CONCLUSIONS

CMV PI and CI in preterm infants from highly seropositive mothers was high, but the rate of symptomatic infection was low. The prevalent genotype was gB2, and this genotype was preferentially transmitted to newborns by mothers with mixed infections.

摘要

引言

先天性巨细胞病毒(CMV)感染(CI)和围产期巨细胞病毒感染(PI)可能与母亲CMV血清学阳性有关,对早产儿会产生致命后果。糖蛋白B(gB)基因分型已用于分析母婴之间的基因相似性。本研究调查了母亲血清学阳性背景下CMV感染的频率、病毒gB基因型以及母婴之间基因相似性。

方法

从出生至出生后第一个月每周采集早产儿的唾液样本和干血斑(DBS),并在哺乳期第一个月每周采集其母亲的母乳样本。确定母亲的CMV IgG血清阳性率以及婴儿的CI或PI情况。回顾性分析DBS和母乳样本中的gB状态和基因相似性。

结果

共纳入387例新生儿和375例母亲。母亲CMV IgG血清学阳性率为97.3%(365/375)。5.1%(20/387)的新生儿检测到CMV,1例婴儿出现与CMV相符的症状。CI为2.5%,出生后第一个月的PI为11.8%。GB2是最常见的基因型,也是混合感染母亲优先传播给新生儿的基因型。

结论

血清学高度阳性母亲所生早产儿的CMV PI和CI发生率较高,但有症状感染率较低。流行基因型为gB2,该基因型由混合感染母亲优先传播给新生儿。

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