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印度尼西亚雅加达一个城市出生队列中先天性巨细胞病毒感染的出生患病率和特征。

Birth prevalence and characteristics of congenital cytomegalovirus infection in an urban birth cohort, Jakarta, Indonesia.

机构信息

Department of Pediatrics, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Eijkman Institute for Molecular Biology, Jakarta, Indonesia.

出版信息

Int J Infect Dis. 2019 Sep;86:31-39. doi: 10.1016/j.ijid.2019.06.009. Epub 2019 Jun 14.

DOI:10.1016/j.ijid.2019.06.009
PMID:31207385
Abstract

OBJECTIVES

Little is known about the birth prevalence and characteristics of congenital cytomegalovirus (CMV) infection in developing countries. To determine the prevalence and characteristics of congenital CMV infection in Indonesia, we conducted a prospective study in an urban birth cohort of neonates at a national referral hospital in 2016-2017, Jakarta, Indonesia.

METHODS

Consecutively born neonates were screened for the presence of CMV by using pan-herpesvirus nested-PCR and Sanger sequencing in saliva and/or urine specimens. Both the neonatal clinical findings as well as maternal characteristics were also evaluated.

RESULTS

From a total of 411 newborns screened, congenital CMV infection was confirmed in 5.8% of the neonates. These CMV-positive newborns were more likely to have ventriculomegaly and thrombocytopenia compared to CMV-negative neonates. Notably, 67% CMV-positive neonates in our study had clinical findings that required medical intervention, from which only nine presented with symptoms suggestive of congenital CMV infection. Furthermore, congenital CMV infected babies were almost four times more likely to be born to mothers that had placenta previa and placental abruption.

CONCLUSIONS

Our work highlights the high prevalence of congenital CMV infection in neonates born in one of the biggest referral hospitals in metropolitan Jakarta, Indonesia.

摘要

目的

在发展中国家,先天性巨细胞病毒(cytomegalovirus,CMV)感染的出生流行率和特征知之甚少。为了确定印度尼西亚先天性 CMV 感染的流行率和特征,我们在 2016 年至 2017 年期间在雅加达的一家国家转诊医院对一个城市新生儿队列进行了前瞻性研究。

方法

连续出生的新生儿通过使用泛疱疹病毒巢式 PCR 和 Sanger 测序在唾液和/或尿液标本中筛查 CMV 的存在。同时评估新生儿的临床发现和产妇特征。

结果

在总共筛查的 411 名新生儿中,有 5.8%的新生儿确诊为先天性 CMV 感染。与 CMV 阴性新生儿相比,这些 CMV 阳性新生儿更有可能出现脑室扩张和血小板减少症。值得注意的是,在我们的研究中,67%的 CMV 阳性新生儿需要医疗干预,其中只有 9 名出现了先天性 CMV 感染的症状。此外,患有先天性 CMV 感染的婴儿更有可能出生于患有前置胎盘和胎盘早剥的母亲。

结论

我们的工作强调了印度尼西亚雅加达最大的转诊医院之一的新生儿先天性 CMV 感染的高流行率。

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