Universal Screening for Congenital CMV Infection

Lunardi, Sara; Lorenzoni, Francesca; Ghirri, Paolo

doi:10.5772/intechopen.89611

Cited by 8 publications

(6 citation statements)

References 43 publications

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“…A high incidence of congenital CMV infection in preterm infants has been previously reported: congenital infection was identified in 8 (2.4%) of 342 (≤31 weeks gestation and birth weight ≤1500 g) in a study carried out in Spain and in 10 (3%) of 329 preterm infants (<37 weeks gestation) in a study carried out in Italy 37,38 . As a result, universal screening for congenital CMV infection in very preterm infants is recommended by several authors 32,33,42 . In contrast, other studies have reported the incidence of congenital CMV infection to be similar, or even lower, in preterm infants compared to term infants 34,39,43 .…”

Section: Discussionmentioning

confidence: 95%

“…37,38 As a result, universal screening for congenital CMV infection in very preterm infants is recommended by several authors. 32,33,42 In contrast, other studies have reported the incidence of congenital CMV infection to be similar, or even lower, in preterm infants compared to term infants. 34,39,43 As such, further research is required to determine if the incidence of congenital CMV infection is greater in preterm infants.…”

Section: Discussionmentioning

confidence: 96%

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

Cadena‐Mota

Muñoz‐Escalante

Martínez‐Rodríguez

et al. 2022

Journal of Medical Virology

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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.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 96%

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

Cadena‐Mota

Muñoz‐Escalante

Martínez‐Rodríguez

et al. 2022

Journal of Medical Virology

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“…In turn, increased awareness encourages parent queries and drives more providers to perform cCMV screening despite absent or limited CPGs. Participants similarly emphasized the documented benefits of early interventions on the long-term outcomes of hearing loss, developmental delay, and other conditions with variable causes, including cCMV infection [ 35 , 36 ]. Evidence of these benefits regardless of etiology provides rationale for cCMV screening and may transform formal CPGs and/or local clinical practice patterns.…”

Section: Resultsmentioning

confidence: 99%

A Qualitative Assessment of Clinical Practice Guidelines and Patterns for Congenital Cytomegalovirus in the United States

Kalb,

Diaz-Decaro,

Tossonian

et al. 2023

IJNS

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Cytomegalovirus (CMV) infection during pregnancy may result in long-term health problems for children with congenital CMV (cCMV). Currently, no prevention or treatment interventions are approved by the Food and Drug Administration for a cCMV indication. Healthcare provider and public awareness is low, and formal clinical practice guidelines and local practice patterns vary. A pilot study of eight cCMV experts was performed using qualitative semi-structured interviews to better understand clinical practice guidelines and patterns in the United States. Results from participant interviews highlighted the need for better prenatal diagnostic techniques, broader neonatal screening opportunities, and more robust evidence supporting intervention strategies. Healthcare provider and public partnerships are essential for advancing cCMV guidelines and improving care delivery. Our results provide a preliminary knowledge base and framework for developing a consensus cCMV research agenda to address evidence gaps that limit the revision of clinical practice guidelines. The changes in clinical practice patterns that may arise as a result of further research have the potential to reduce risk during pregnancy and improve care for children with cCMV infection.

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“…En suma, un programa de cribado universal de infección por CMVc permitiría evaluar oportunamente al RN, considerar el tratamiento y realizar un seguimiento activo a largo plazo, agregados a potenciales beneficios sociales y en salud pública por disminución de carga y costo por discapacidad 58 . Los estudios de costo-beneficio realizados, tanto para cribado universal como en grupos de riesgo, han mostrado utilidad 59 ; sin embargo, en lugares con recursos limitados, el cribado universal pareciera ser impracticable por ahora, sobre todo porque el tratamiento del RN asintomático sigue siendo controversial. En nuestra realidad se podría recomendar, al menos, el cribado en grupos de riesgo: RN que refieren el estudio auditivo al nacer, hijos de madre con infección por VIH, prematuros extremos, PEG severos y en todo aquel que se sospecha por antecedentes prenatales o manifestaciones clínicas al nacer.…”

Section: Discussionunclassified

Cribado de infección por citomegalovirus congénito en recién nacidos de alto riesgo

Hernández

Bacigualupo

et al. 2021

Rev. chil. infectol.

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Introducción: La infección congénita por citomegalovirus (CMVc) es la causa más frecuente de infección intrauterina, 90% de los recién nacidos (RN) son asintomáticos al nacer y 6 a 15% desarrollarán secuelas a largo plazo, siendo la principal etiología de hipoacusia sensorio-neural no-genética. Objetivo: Determinar la prevalencia de CMVc en RN de alto riesgo. Pacientes y Método: Estudio de cohorte prospectivo, incluyó RN hospitalizados, con uno o más de los siguientes criterios: peso de nacimiento < 1.500 g, < 32 semanas edad gestacional (EG), pequeños para edad gestacional (PEG) severos, sospecha de infección congénita o que "no pasan" en estudio auditivo al nacer, además de hijos de madre con infección por VIH. Se realizó reacción de polimerasa en cadena para CMV en orina antes de 21 días de vida. Resultados: Se enrolaron 193 RN. Prevalencia global CMVc 2,6% (n: 5) y por grupo de riesgo: 1/3 (n: 1) en RN con sospecha activa de infección congénita, 8,3% en RN con resultado "no pasa" en estudio auditivo, 4,9% en hijos de madre con infección por VIH, 3,3% en PEG severo y 1,7% < 1500 g, ninguno con asociación significativa. Sólo un paciente con CMVc fue sintomático, quien falleció en el período neonatal y los restantes RN con CMVc (asintomáticos) tienen seguimiento auditivo normal. Discusión: La prevalencia reportada es comparable a las internacionales. Recomendamos cribado de CMVc, al menos en grupos de riesgo, siendo lo ideal el cribado universal. Esto permitiría su tratamiento oportuno y un seguimiento activo.

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Universal Screening for Congenital CMV Infection

Cited by 8 publications

References 43 publications

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

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

A Qualitative Assessment of Clinical Practice Guidelines and Patterns for Congenital Cytomegalovirus in the United States

Cribado de infección por citomegalovirus congénito en recién nacidos de alto riesgo

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