针对新生儿听力筛查未通过的婴儿进行先天性巨细胞病毒感染的靶向筛查计划的结果。
Results of a Targeted Screening Program for Congenital Cytomegalovirus Infection in Infants Who Fail Newborn Hearing Screening.
机构信息
Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.
出版信息
J Pediatric Infect Dis Soc. 2019 Mar 28;8(1):55-59. doi: 10.1093/jpids/pix105.
BACKGROUND
Congenital cytomegalovirus (CMV) infection is a major cause of sensorineural hearing loss. By law, newborns in Connecticut who fail newborn hearing screening are tested for infection with CMV. This targeted screening is controversial, because most children with congenital CMV infection are asymptomatic, and CMV-related hearing loss can have a delayed onset. Our hospital uses a saliva polymerase chain reaction (PCR) assay (confirmed by a urine PCR assay) to detect CMV. Here, we report the results of the first year of our screening program.
METHODS
We reviewed the medical records of newborns in the Yale New Haven Health System who failed the newborn hearing screening test between January 1 and December 31, 2016.
RESULTS
Of 10964 newborns, 171 failed newborn hearing screening, and 3 of these newborns had positive saliva CMV PCR test results. Of these 3 newborns, 2 had positive results on the confirmatory test (for 1 of them the confirmatory test was not performed until the infant was 10 weeks old), and 1 had a negative result on the confirmatory test. Three additional newborns with congenital CMV infection were tested because of clinical indications (1 for ventriculomegaly on prenatal ultrasound and 2 for CMV infection of the mother). Results of audiology follow-up were available for 149 (87.1%) of the 171 newborns who failed newborn hearing screening; 127 (85.2%) had normal results.
CONCLUSION
Our targeted screening program for congenital CMV infection had a low yield. Consideration should be given to other strategies for identifying children at risk of hearing loss as a result of congenital CMV infection.
背景
先天性巨细胞病毒（CMV）感染是感音神经性听力损失的主要原因。根据法律规定，康涅狄格州新生儿如果未能通过新生儿听力筛查，需要接受 CMV 感染检测。这种有针对性的筛查存在争议，因为大多数先天性 CMV 感染的儿童无症状，且 CMV 相关性听力损失可能延迟发生。我院使用唾液聚合酶链反应（PCR）检测（尿液 PCR 检测结果确认）来检测 CMV。在此，我们报告该筛查项目开展第一年的结果。
方法
我们回顾了 2016 年 1 月 1 日至 12 月 31 日期间在耶鲁纽黑文卫生系统中未能通过新生儿听力筛查的新生儿的病历。
结果
在 10964 名新生儿中，有 171 名新生儿未能通过新生儿听力筛查，其中 3 名新生儿的唾液 CMV PCR 检测结果呈阳性。这 3 名新生儿中，有 2 名在确认性检测中呈阳性（其中 1 名婴儿直到 10 周大时才进行确认性检测），1 名婴儿在确认性检测中呈阴性。另有 3 名先天性 CMV 感染的新生儿因临床指征进行了检测（1 名产前超声检查发现脑室扩大，2 名母亲 CMV 感染）。在未能通过新生儿听力筛查的 171 名新生儿中，有 149 名（87.1%）的听力随访结果可用，其中 127 名（85.2%）正常。
结论
我们的先天性 CMV 感染靶向筛查项目的检出率较低。应考虑其他策略来识别因先天性 CMV 感染而有听力损失风险的儿童。
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