Incidence of congenital and postnatal cytomegalovirus infection during the first year of life in Mexican preterm infants

Abstract

Cytomegalovirus infection occurs commonly during infancy. Postnatal infection in term infants is usually asymptomatic; however, infection in preterm infants can be associated with clinical manifestations during the neonatal period. Nevertheless, few studies to assess the frequency of cytomegalovirus infection in preterm infants have been performed outside of high‐income countries. We analyzed the incidence of congenital and postnatal cytomegalovirus infection in a cohort of preterm infants. Cytomegalovirus infection was detected during the neonatal period in four of 178 infants; in three of them, the virus was detected during the first 3 weeks of life and, therefore, congenital infection was confirmed (1.7% incidence). Postnatal infection was detected in 44 (36.4%) of 121 infants who were assessed after discharge from the neonatal intensive care unit. Cytomegalovirus infection was significantly associated with the duration of breastfeeding. In addition, we characterized cytomegalovirus strains detected in infants together with sequences available at GenBank, based on sequences of the UL18 gene. Cytomegalovirus UL18‐sequences clustered in five distinct clades (A–E), and sequences obtained from infants in our study were distributed in four of the five clades; 44.4% of these sequences were included in clade E. Breastfeeding duration was shorter on average (5.6 months) in infants with sequences in clade E compared to infants with sequences in the other three clades (8.2 months; p = .07). In conclusion, we provide information regarding the high incidence of cytomegalovirus infection in preterm infants. Further studies are warranted to assess if cytomegalovirus strain characteristics are associated with the risk of infection acquisition during infancy.

An Overview of Cytomegalovirus Infection in Pregnancy

“…From the high proportion of asymptomatic newborns, 5–15% present with several sequelae related to CMV infection, especially neurosensorial hearing loss [ 94 , 95 ]. If symptoms are clinically detected, sequelae are more frequent, in approximately 50% of postpartum cases within the first year of life [ 96 ]. Children present hearing loss, cerebral palsy, vision disorders, and intellectual disabilities, as well as other specific manifestations related to previous intrauterine organ involvement [ 97 , 98 ].…”

Ocular Infection of HCMV: Immunology, Pathogenesis, and Interventions

“…HCMV retinitis is a clinical syndrome characterized by full-thickness necrotizing retinitis, which can result in profound vision loss, retinal detachment, and permanent vision loss [21]. The possible transmission paths of HCMV include blood, prenatal intrauterine infection, perinatal infection through breast milk or genital secretions, saliva, and sperm [22,23].…”