Pediatric Infectious Diseases Unit, Soroka Medical Center, Beer Sheva, Israel.
Department of Pediatrics, Faculty of Health Sciences, Ben Gurion University in the Negev, Beer Sheva, Israel.
Infect Dis (Lond). 2020 Oct;52(10):730-735. doi: 10.1080/23744235.2020.1779342. Epub 2020 Jun 18.
The aims of this study were to evaluate the incidence of congenital cytomegalovirus (CMV) in term and near-term infants who fail hearing screen (target screening), the incidence of congenital CMV infections in infants born before 33 weeks of gestation (universal screening) and the incidence of infants who need pharmacologic treatment for congenital CMV associated sensorineural hearing loss (SNHL). This was a retrospective cohort study that assessed two groups of infants born between 2014 and 2017. The first group consisted of infants born between 33 and 42 weeks gestation and the second group, of infants born before 33 weeks gestation. Targeted CMV screening was performed in the first group who either failed neonatal hearing screen or were growth retarded. Universal screen was performed in the second group of infants. CMV DNA was tested in urine samples using real time PCR soon after birth. In the first group, 2078 infants were assessed, 19 (0.9%) were found to be CMV positive and in 9 (42%) valganciclovir treatment was initiated. In the second group, out of 549 urine samples/infants, none was positive for CMV DNA soon after birth. A joint strategy of targeted CMV screening in infants who fail hearing screen test with universal screen of premature infants can select infants at risk of hearing impairment due to congenital CMV soon after birth, allows for timely initiation of treatment and prevents dilemmas regarding congenital CMV diagnosis in infants who fail hearing screen in a later age until universal screen will be widely adopted.
本研究旨在评估在通过听力筛查（目标筛查）的足月和近足月婴儿中先天性巨细胞病毒（CMV）的发生率、在妊娠 33 周前出生的婴儿中先天性 CMV 感染的发生率（普遍筛查），以及需要药物治疗先天性 CMV 相关感音神经性听力损失（SNHL）的婴儿的发生率。这是一项回顾性队列研究，评估了 2014 年至 2017 年间出生的两组婴儿。第一组为妊娠 33 至 42 周的婴儿，第二组为妊娠 33 周前出生的婴儿。第一组对既未通过新生儿听力筛查又生长迟缓的婴儿进行目标性 CMV 筛查。对第二组婴儿进行普遍性筛查。在出生后不久，使用实时 PCR 检测尿液样本中的 CMV DNA。在第一组中，评估了 2078 名婴儿，发现 19 名（0.9%）为 CMV 阳性，9 名（42%）开始使用缬更昔洛韦治疗。在第二组中，549 个尿液样本/婴儿中，没有一个在出生后不久就检测到 CMV DNA 呈阳性。对未能通过听力筛查的婴儿进行目标性 CMV 筛查，对早产儿进行普遍性筛查，这一联合策略可以在婴儿出生后不久筛选出因先天性 CMV 而有听力损伤风险的婴儿，从而及时开始治疗，并避免在普遍筛查广泛采用之前，因婴儿在后期未能通过听力筛查而对先天性 CMV 诊断产生争议。
