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Related Concept Videos

Cytomegalovirus Disease01:27

Cytomegalovirus Disease

Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...

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Implementing a Hearing-Targeted Congenital CMV Screening Program in a Low-Prevalence Region.

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Newborn hearing-targeted screening (HTS) achieved 100% adherence for congenital cytomegalovirus (cCMV) detection. However, only one case of cCMV was confirmed, suggesting alternative screening methods may be needed.

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Area of Science:

  • Neonatology
  • Infectious Diseases
  • Public Health

Background:

  • Congenital cytomegalovirus (cCMV) is a leading nongenetic cause of sensorineural hearing loss in newborns.
  • Existing hearing-targeted screening (HTS) programs for cCMV exhibit variable adherence and detection rates.
  • Effective screening strategies are crucial for early identification and intervention.

Purpose of the Study:

  • To implement and assess a comprehensive cCMV HTS program in a newborn nursery.
  • To evaluate the adherence and yield of a nurse-driven HTS algorithm for cCMV detection.
  • To determine the effectiveness of saliva and urine PCR testing for cCMV screening.

Main Methods:

  • Implementation of a nurse-driven HTS algorithm and follow-up process for cCMV screening in December 2018.
  • cCMV screening using saliva polymerase chain reaction (PCR), with confirmatory urine PCR within 21 days of birth.
  • Utilized an annotated run chart to monitor screening adherence and outcomes over time.

Main Results:

  • Screening adherence increased from 0% to 100% within the first 23 quarters post-implementation.
  • Of 650 newborns referred for hearing screening, 13 had positive saliva screens.
  • Only one newborn was confirmed with cCMV infection; 12 cases were false positives.

Conclusions:

  • The implemented HTS program achieved high adherence for cCMV screening.
  • The low yield of confirmed cCMV cases suggests a need for re-evaluation of screening strategies in low-prevalence settings.
  • Balancing feasibility and diagnostic yield is essential when considering alternative cCMV screening approaches.