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台湾地区育龄妇女及新生儿巨细胞病毒血症的流行状况和基因型分布。

Prevalence of cytomegalovirus DNAemia and genotypic distribution among childbearing mothers and neonates in Taiwan.

机构信息

Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.

Department of Obstetrics and Gynecology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.

出版信息

Int J Infect Dis. 2020 Feb;91:240-245. doi: 10.1016/j.ijid.2019.11.025. Epub 2019 Nov 26.

Abstract

BACKGROUND

Congenital cytomegalovirus (CMV) infection is the leading cause of neurologic disabilities and sensorineural hearing loss in children. However, in Taiwan, there is limited information on the genotypic diversity and prevalence of perinatal CMV infection in both mothers and neonates. The aim of this study was to screen samples from both mothers and umbilical cord blood for CMV at the time of delivery and to determine the CMV genotypic distribution.

METHODS

Between June 2012 and July 2015, residual maternal and umbilical cord blood samples were collected from consenting participants admitted to the Chang Bing Show Chwan Memorial Hospital in central Taiwan. The blood samples were screened for CMV DNA using real-time PCR assay, and the genotypic classification of the CMV UL55, UL144, and US28 genes was determined by sequencing and phylogenetic analysis.

RESULTS

A total of 1282 mother-neonate paired samples were enrolled in the study, 95.3% of whom were Taiwanese. CMV DNA was detectable in 6.2% of the maternal blood samples, with a significantly higher rate noted in non-Taiwanese mothers (11.7%,p=0.027). For the 1,282 umbilical cord blood samples, CMV DNA was detectable in 5.3% of the samples. The presence of CMV DNA in maternal blood was positively associated with the presence of CMV DNA in umbilical cord blood (p=0.01). In addition, the UL55, UL144, and US28 genotypic distribution was similar between mothers and neonates.

CONCLUSION

The prevalence of CMV DNAemia in childbearing mothers and neonates is similar and their genotypic distribution implies potential CMV infection during pregnancy.

摘要

背景

先天性巨细胞病毒(CMV)感染是导致儿童神经残疾和感觉神经性耳聋的主要原因。然而,在台湾,关于母婴围生期 CMV 感染的基因型多样性和流行率的信息有限。本研究旨在分娩时对母亲和脐带血样本进行 CMV 筛查,并确定 CMV 基因型分布。

方法

2012 年 6 月至 2015 年 7 月,我们从同意参加研究的中台湾长庚纪念医院的产妇中收集剩余的母亲和脐带血样本。使用实时 PCR 检测法对血液样本进行 CMV DNA 筛查,并通过测序和系统发育分析确定 CMV UL55、UL144 和 US28 基因的基因型分类。

结果

共有 1282 对母婴样本被纳入本研究,其中 95.3%为台湾人。母亲血液样本中可检测到 6.2%的 CMV DNA,非台湾母亲的检出率明显更高(11.7%,p=0.027)。对于 1282 份脐带血样本,有 5.3%的样本可检测到 CMV DNA。母亲血液中 CMV DNA 的存在与脐带血中 CMV DNA 的存在呈正相关(p=0.01)。此外,母亲和新生儿的 UL55、UL144 和 US28 基因型分布相似。

结论

产妇和新生儿 CMV DNA 血症的流行率相似,其基因型分布提示妊娠期存在潜在的 CMV 感染。

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