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Cytomegaloviruria in older infants in intensive care nurseries
Insights
Cytomegalovirus (CMV) infection is common in premature infants in intensive care nurseries. CMV shedding was linked to premature birth and blood transfusions, highlighting potential transmission risks.
Area of Science:
- Neonatalogy
- Virology
- Infectious Diseases
Background:
- Cytomegalovirus (CMV) is a common congenital infection.
- Neonatal intensive care units (NICUs) harbor vulnerable infant populations.
- Understanding CMV transmission in NICUs is crucial for infant health.
Purpose of the Study:
- To investigate the prevalence and potential risk factors of cytomegalovirus (CMV) shedding in infants in intensive care nurseries.
- To identify associations between CMV viruria and factors like prematurity and blood product exposure.
Main Methods:
- Weekly urine specimen collection for viral isolation over a four-month period.
- Analysis of infants older than three weeks in two NICUs, representing 43% of the patient population.
- Statistical comparison of CMV shedding rates between infants with and without specific risk factors.
Main Results:
- Cytomegalovirus was cultured from 14% (13 of 93) of surveyed infants.
- Premature infants were more likely to excrete CMV, with 9 of 11 shedding before 40 weeks postconception.
- CMV-excreting infants received significantly more blood transfusions from different donors (P < 0.002) and were more likely to have undergone exchange transfusions (P < 0.05).
Conclusions:
- Prematurity and exposure to blood transfusions are significant risk factors for CMV shedding in NICU infants.
- Blood transfusions may play a role in CMV transmission within the NICU setting.
- Further research into CMV reservoirs and transmission dynamics in NICUs is warranted.
Abstract:
Over a four-month period, urine specimens for viral isolation were obtained weekly from all infants older than three weeks in two intensive care nurseries. These babies comprised 43% of the patients in the nurseries surveyed. Cytomegalovirus was cultured from 13 of 93 (14%) of these infants. Eleven of 13 infants who developed cytomegaloviruria were born prematurely, and nine of these 11 were found to be excreting CMV before they reached 40 weeks postconception. Infants excreting CMV received blood transfusions from a mean of 10.45 (+/- 1.80 SE) different donors versus 5.10 (+/- 0.55 SE) for infants without viruria (P less than 0.002) and five of 14 infants undergoing one or more exchange transfusions developed cytomegaloviruria (P less than 0.05). The possible role of other CMV reservoirs and the importance of these findings are discussed.