[高危新生儿先天性巨细胞病毒感染筛查]

[Congenital cytomegalovirus infection screening in high risk newborn].

作者信息

Chuang Chuang Ángela, Ramos Hernández Hernán, Zelada Bacigualupo Úrsula, López Castillo María Teresa, Villavicencio Landeros Leonel, Peret Luisa Montecinos, González Muñoz Claudio, Barría Espinoza Tamara, Izquierdo Copiz Giannina

机构信息

Servicio de Otorrinolaringología, Complejo Asistencial Barros Luco Trudeau, Santiago, Chile.

Servicio de Fonoaudiología, Complejo Asistencial Barros Luco Trudeau, Santiago, Chile.

出版信息

Rev Chilena Infectol. 2021 Feb;38(1):45-53. doi: 10.4067/S0716-10182021000100045.

DOI:10.4067/S0716-10182021000100045

PMID:33844792

Abstract

BACKGROUND

Congenital cytomegalovirus infection (cCMV) is the most frequent cause of congenital infection, 90% of affected newborn (NB) are asymptomatic at birth and 6-15% will develop long term sequalae. It is the main etiology of non-genetic sensorineural hearing loss.

AIM

To determine prevalence of CMV in high risk NB.

METHODS

Cohort prospective study, including inpatient NB with one or more of following criteria: birth weight < 1,500 g, < 32 weeks gestational age (GA), severe small for gestational age (SGA), suspected congenital infection or "refer" in newborn hearing test, also NB to HIV-infected mothers. Urine CMV polymerase chain reaction was performed within 21 day of life.

RESULTS

193 NB were enrolled. Global cCMV prevalence 2.6% (n: 5) and by risk group: one third (n: 1) in NB with suspected congenital infection, 8.3% in NB with "refer" result in hearing test, 4.9% in NB to HIV-infected mothers, 3.3% in severe SGA and 1.7% in < 1,500 g, none with significant association. Only one symptomatic cCMV was detected who died in neonatal period and the remaining (asymptomatic) cCMV patients have normal hearing follow-up.

DISCUSSION

Reported prevalence was comparable to international reports. We recommend cCMV screening, at least in risk groups, being ideal the universal screening. This would allow timely treatment and active follow-up.

摘要

背景

先天性巨细胞病毒感染（cCMV）是先天性感染最常见的原因，90%受影响的新生儿（NB）出生时无症状，6%-15%会出现长期后遗症。它是非遗传性感音神经性听力损失的主要病因。

目的

确定高危新生儿中CMV的患病率。

方法

队列前瞻性研究，纳入符合以下一项或多项标准的住院新生儿：出生体重<1500g、胎龄（GA）<32周、严重小于胎龄（SGA）、疑似先天性感染或新生儿听力测试“转诊”，以及母亲感染HIV的新生儿。在出生后21天内进行尿CMV聚合酶链反应检测。

结果

共纳入193例新生儿。总体cCMV患病率为2.6%（n = 5），按风险组划分：疑似先天性感染的新生儿中三分之一（n = 1），听力测试“转诊”结果的新生儿中为8.3%，母亲感染HIV的新生儿中为4.9%，严重SGA的新生儿中为3.3%，<1500g的新生儿中为1.7%，均无显著相关性。仅检测到1例有症状的cCMV患儿，死于新生儿期，其余（无症状）cCMV患儿听力随访正常。