Wunderlich Whitney, Sidebottom Abbey C, Schulte Anna K, Taghon Jessica, Dollard Sheila, Hernandez-Alvarado Nelmary
Care Delivery Research, Allina Health, Minneapolis, MN 55410, USA.
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Int J Neonatal Screen. 2023 Aug 17;9(3):46. doi: 10.3390/ijns9030046.
A universal screening research study was conducted in six hospitals to identify the clinical sensitivity of polymerase chain reaction (PCR) testing on newborn dried blood spots (DBSs) versus saliva specimens for the diagnosis of congenital cytomegalovirus (cCMV). CMV DNA positive results from DBSs or saliva were confirmed with urine testing. Findings of several false-positive (FP) saliva PCR results prompted an examination of a possible association with donor milk. Documentation of the frequency of positive saliva results, including both true-positive (TP) and FP status from clinical confirmation, occurred. The frequency of donor milk use was compared for TP and FP cases. Of 22,079 participants tested between 2016 and 2022, 96 had positive saliva results, 15 were determined to be FP, 79 TP, and 2 were excluded for incomplete clinical evaluation. Newborn donor milk use was identified for 18 (19.14%) of all the positive saliva screens. Among the 15 FPs, 11 (73.33%) consumed donor milk compared to 7 of the 79 TPs (8.8%) (OR 28.29, 95% CI 7.10-112.73, < 0.001). While milk bank Holder pasteurization inactivates CMV infectivity, CMV DNA may still be detectable. Due to this possible association, screening programs that undertake testing saliva for CMV DNA may benefit from documenting donor milk use as a potential increased risk for FP results.
在六家医院开展了一项通用筛查研究，以确定聚合酶链反应（PCR）检测新生儿干血斑（DBS）与唾液标本对先天性巨细胞病毒（cCMV）诊断的临床敏感性。DBS或唾液的CMV DNA阳性结果通过尿液检测进行确认。唾液PCR结果出现的几个假阳性（FP）促使对其与捐赠母乳的可能关联进行检查。记录了唾液阳性结果的频率，包括临床确认的真阳性（TP）和FP情况。比较了TP和FP病例中使用捐赠母乳的频率。在2016年至2022年期间接受检测的22,079名参与者中，96人唾液结果呈阳性，15人被确定为FP，79人为TP，2人因临床评估不完整而被排除。在所有唾液阳性筛查中，有18例（19.14%）新生儿使用了捐赠母乳。在15例假阳性中，11例（73.33%）食用了捐赠母乳，而79例真阳性中有7例（8.8%）（比值比28.29，95%置信区间7.10 - 112.73，P < 0.001）。虽然母乳库的Holder巴氏灭菌法可使CMV失去感染性，但CMV DNA可能仍可检测到。由于这种可能的关联，进行CMV DNA唾液检测的筛查项目可能会受益于记录捐赠母乳的使用情况，因为这可能会增加假阳性结果的风险。
