Orb Quinn T, Pesch Megan, Allen Chelsea M, Wilkes Ashlea, Ahmad Iram, Alfonso Kristan, Antonio Stephanie Moody, Mithal Leena Bhattacharya, Brinkmeier Jennifer V, Carvalho Daniela, Chan Dylan, Cheng Alan G, Chi David, Cohen Michael, Discolo Christopher Michael, Duran Carlos, Germiller John, Gibson Laura, Grunstein Eli, Harrison Gail, Lee Kenneth, Hawley Karen, Kohlhoff Stephan, Melvin Ann, MacArthur Carol, Nassar Michel, Neff Laura, Pecha Phayvanh, Salvatore Christine, Schoem Scott, Virgin Frank, Saunders James, Schleiss Mark, Smith Richard J H, Sood Sunil, Park Albert H
Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA.
ValEAR Study Group, Worcester, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2024 May;170(5):1430-1441. doi: 10.1002/ohn.670. Epub 2024 Feb 28.
To determine the positivity rate of congenital cytomegalovirus (cCMV) testing among universal, hearing-targeted CMV testing (HT-cCMV) and delayed targeted dried blood spot (DBS) testing newborn screening programs, and to examine the characteristics of successful HT-cCMV testing programs.
Prospective survey of birth hospitals performing early CMV testing.
Multiple institutions.
Birth hospitals participating in the National Institutes of Health ValEAR clinical trial were surveyed to determine the rates of cCMV positivity associated with 3 different testing approaches: universal testing, HT-cCMV, and DBS testing. A mixed methods model was created to determine associations between successful HT-cCMV screening and specific screening protocols.
Eighty-two birth hospitals were surveyed from February 2019 to December 2021. Seven thousand six hundred seventy infants underwent universal screening, 9017 infants HT-cCMV and 535 infants delayed DBS testing. The rates of cCMV positivity were 0.5%, 1.5%, and 7.3%, respectively. The positivity rate for universal CMV screening was less during the COVID-19 pandemic than that reported prior to the pandemic. There were no statistically significant drops in positivity for any approach during the pandemic. For HT-cCMV testing, unique order sets and rigorous posttesting protocols were associated with successful screening programs.
Rates of cCMV positivity differed among the 3 approaches. The rates are comparable to cohort studies reported in the literature. Universal CMV prevalence decreased during the pandemic but not significantly. Institutions with specific order set for CMV testing where the primary care physician orders the test and the nurse facilitates the testing process exhibited higher rates of HT-cCMV testing.
确定在普遍检测、针对听力的巨细胞病毒检测（HT-cCMV）和延迟靶向干血斑（DBS）检测的新生儿筛查项目中先天性巨细胞病毒（cCMV）检测的阳性率，并研究成功的HT-cCMV检测项目的特点。
对进行早期巨细胞病毒检测的分娩医院进行前瞻性调查。
多个机构。
对参与美国国立卫生研究院ValEAR临床试验的分娩医院进行调查，以确定与3种不同检测方法相关的cCMV阳性率：普遍检测、HT-cCMV和DBS检测。创建了一个混合方法模型，以确定成功的HT-cCMV筛查与特定筛查方案之间的关联。
在2019年2月至2021年12月期间对82家分娩医院进行了调查。7670名婴儿接受了普遍筛查，9017名婴儿接受了HT-cCMV检测，535名婴儿接受了延迟DBS检测。cCMV阳性率分别为0.5%、1.5%和7.3%。在新冠疫情期间，普遍巨细胞病毒筛查的阳性率低于疫情之前报告的阳性率。在疫情期间，任何一种检测方法的阳性率均无统计学意义上的下降。对于HT-cCMV检测，独特的医嘱集和严格的检测后方案与成功的筛查项目相关。
3种检测方法的cCMV阳性率有所不同。这些比率与文献中报道的队列研究结果相当。在疫情期间，普遍巨细胞病毒感染率有所下降，但降幅不显著。对于CMV检测有特定医嘱集的机构，即由初级保健医生开具检测医嘱且护士协助检测过程，其HT-cCMV检测率较高。
