Analysis of an Expanded Targeted Early Cytomegalovirus Testing Program.

Area of Science:

• Neonatal screening
• Infectious disease diagnostics
• Public health interventions

Background:

• Congenital cytomegalovirus (cCMV) is a leading cause of non-genetic sensorineural hearing loss and neurodevelopmental disabilities.
• Early detection and intervention are crucial for improving outcomes in infants with cCMV.
• Current screening strategies vary, with limitations in detection rates and accessibility.

Purpose of the Study:

• To evaluate the detection rate of symptomatic congenital CMV (cCMV) infections using an expanded targeted early testing program.
• To assess the feasibility and effectiveness of this program as an alternative to universal or hearing-targeted screening.

Main Methods:

• A retrospective review of CMV testing data was conducted within a large healthcare system (Intermountain Healthcare).
• An electronic system was modified to prompt CMV testing orders based on specific clinical indications.
• Analysis included live births, CMV test orders, indications for testing, and diagnosed cCMV cases.

Main Results:

• Over 39,000 live births, 3450 (8.8%) underwent CMV testing.
• Annual CMV testing increased nearly tenfold since program implementation in 2019.
• Small for gestational age (SGA) was the most frequent indication (68.2%) for testing.
• Fourteen symptomatic cCMV cases were diagnosed, with SGA being the most common indicator (10 cases).
• The positivity rate indicated a prevalence of 35.7 symptomatic cCMV cases per 100,000 live births.

Conclusions:

• An expanded targeted early CMV testing program effectively increases the detection of symptomatic cCMV cases.
• This approach demonstrates a feasible and potentially more efficient alternative to universal or hearing-targeted screening strategies.
• The findings support the consideration of such targeted programs for early cCMV identification and management.