Abstract
Knowledge of the prevalence of congenital cytomegalovirus infection is necessary to evaluate the need for prevention. We performed a multicentre one-year study involving 11 neonatology divisions to ascertain the prevalence in Lombardy. Cytomegalovirus was isolated by culturing saliva samples from all babies born (n=1268) of two 15-day sample periods and from 185 neonates with suspected congenital CMV based on clinical and laboratory findings and the history. The overall prevalence of congenital infection was 0.47% (6/1268) in the sample period group and 5% (9/185) in the second group. Clinical monitoring revealed sequelae in two of three children with symptomatic infection and no asymptomatic child at age two years. In a subgroup of 205 babies including 14 of the infected infants we also evaluated a test to detect cytomegalovirus DNA in the Guthrie cards obtained in neonatal screening for genetic and metabolic disorders. The test's sensitivity was 100% and specificity 98.5%, encouraging its use for early identification of infected neonates and for large epidemiological studies.
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References
Nelson CT, Demmler GJ. Cytomegalovirus infection in the pregnant mother, fetus, and newborn infant. C1in Perinatol 1997; 24:151-160.
Ahlfors K, Harris S, Ivarsson S, Svanberg L. Secondary maternal cytomegalovirus infection causing symptomatic congenital infection. N Engl J Med 1981; 305: 284.
Rutter D, Griffiths P, Trompeter RS. Cytomegalic inclusion disease after recurrent maternal infection. Lancet 1985; 2:1182.
Morris DJ, Sims D, Chiswick M, Das VK, Newton VE. Symptomatic congenital cytomegalovirus infection after maternal recurrent infection. Pediatr Infect Dis J 1994; 13: 61-64.
Balcarek KB, Warren W, Smith RJ, et al. Neonatal screening for congenital cytomegalovirus infection by detection of virus in saliva. J Infect Dis 1993; 167:1433-1436.
Barbi M, Binda S, Primache V, Corbetta C. Diagnosis of congenital cytomegalovirus infection by detection of viral DNA in dried blood spots. Clin Diagn Virol 1996; 6: 27-32.
Wakefield AJ, Fox JD, Sawyerr AM, et al. Detection of herpesvirus DNA in the large intestine of patients with ulcerative colitis and Côohn's disease using nested polymerase chain reaction. J Med Virol 1992; 38:183-190.
Barbi M, Cappellini D, Ferrante P, et al. Infezioni congenite da Cytomegalovirus in una Unita di Patologia Neonatale. Boll Ist Sieroter Milan 1985; 64: 262-268.
Giaquinto C, Falconi P; Sarctta L, et al. Uinfezione congenita da Cytomegalovirus: studio prospettico. Riv Inf Pediatr 1988; 4: 219-223.
Chiba S, Kamada M, Yoshimura M, et al. Congenital cytomegalovirus infection in Japan. N Engl J Med 1984; 310: 50.
Hirota K, Muraguchi K, Watabe N, et al. Prospective study on maternal, intrauterine, and perinatal infections with cytomegalovirus in Japan during 1976-1990. J Med Virol 1992; 37: 303-306.
Spector SA, Hirata KK, Newman TR. Identification of multiple cytomegalovirus strains in homosexual men with acquired immunodeficiency syndrome. J infect Dis 1984; 150:953-956.
Fowler K, Stagno S, Pass RF, Britt WJ, Boll TJ, Alford CA. The outcome of congenital cytomegalovirus infection in relation to maternal antibody status. N Engl J Med 1992; 326: 663-667.
Peckham C, Newell ML. Longitudinal follow-up studies. Acta Paediatr Suppl 1994; 400: 78-80.
Nigro G, Sholtz H, Bartmann U. Ganciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: A two regimen experience. J Pediatr 1994; 124: 318-322.
Whitley RJ, Cloud G, Gruber W, et al. Ganciclovir treatment of symptomatic congenital cytomegalovirus infection: Results of phase 11 study. J Infect Dis 1997; 175:1080-1086.
Adler SP. Immunoprophylaxis against cytomegalovirus disease. Scand J Infect Dis 1995; S99:105-109.
Revello MG, Baldanti F, Furione M, et al. Polymerase chain reaction for prenatal diagnosis of congenital human cytomegalovirus infection. J Med Virol 1995; 47: 462-466.
Ruellan-Eugene G, Barjot P, Campet M, Vabret A, Herlicoviez M, Muller G, Levy G, Guillois B, Freymuth F. Evaluation of virological procedures to detect fetal human cytomegalovirus infection-avidity of IgG antibodies, virus detection in amniotic fluid and maternal serum. J Med Virol 1996; 50: 9-15.
Sanders J, Niehaus C. Screening test for syphilis-specific antobodies added to a screening program for congenital hypothyroidism. J Pediatr 1982; 100: 93-95.
Stevens R, Pass K, Fuller S, Wiznia A, Noble L, Duva S, Neat M. Blood spot screening and confirmatory tests for syphilis antibody. J Clin Microbiol 1992; 30: 2353-2358.
Cassol S, Sala T, Arella M, Neumann P, Schechter MT, O'Shaughnessy M. Use of dried blood spot specimens in the detection of human immunodeficiency virus type 1 by the polymerase chain reaction. J C1in Microbiol 1991; 29:667-671.
Comeau M, Pitt J, Hillyer GV, Landesman S, Bremer J, Chang BH, Lew J, Moãe J, Grady GF, and McIntosh K for the Women and Infants Transmission Study Group. Early detection of human immunodeficiency virus on dried blood spot specimens: sensitivity across serial specimens. J Pediatr 1996; 129:111-118.
Lebech M, Petersen E. Neonatal screening for congenital toxoplasmosis in Denmark: Presentation of the design of a prospective study. Scand J Inf Dis 1992; 84: S75-S79.
Shibata M, Takano H, Hironaka T, Hirai K. Detection of human cytomegalovirus DNA in dried newborn blood filter paper. J Viro1 Methods 1994, 46: 279-285.
Barbi M, Binda S, Primache V, Corbetta C. Dried new-born blood spots examination allows congenital CMV infection diagnosis. 6th International Cytomegalovirus Workshop, Orange Beach, Alabama, March 5-9,1997. Abstr 193.
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Barbi, M., Binda, S., Primache, V. et al. Congenital cytomegalovirus infection in a northern Italian region. Eur J Epidemiol 14, 791–796 (1998). https://doi.org/10.1023/A:1007554726449
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DOI: https://doi.org/10.1023/A:1007554726449