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Arch Dis Child Fetal Neonatal Ed. 2017 Nov;102(6):F519-F524. doi: 10.1136/archdischild-2016-311859. Epub 2017 May 3.

Contribution of targeted saliva screening for congenital CMV-related hearing loss in newborns who fail hearing screening.

Author information

1
Hearing, Speech and Language Center, Chaim Sheba Medical Center, Ramat Gan, Israel.
2
Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
3
Department of Neonatology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel.
4
Maccabi Healthcare Services, Tel Aviv, Israel.
5
Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
6
Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.
7
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
8
Department of Neonatology, Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel.
9
Pediatric Infectious Disease Unit, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel.

Abstract

BACKGROUND:

We previously reported a 2.2% rate of infants born with sensorineural hearing loss (SNHL) due to congenital cytomegalovirus (cCMV) infection identified by universal neonatal screen for cCMV using saliva.

OBJECTIVE:

To evaluate the contribution of targeted saliva screening for cCMV to the detection of infants born with cCMV-related SNHL who failed universal newborn hearing screening (UNHS).

METHODS:

We retrospectively reviewed the audiological and medical records of infants who failed UNHS and were tested for cCMV using saliva sample prior to discharge at Sheba Medical Center between 2014 and 2015. Positive cases were confirmed by urine sample.

RESULTS:

Two hundred (1%) of the 19 830 infants tested during the study period failed in-hospital hearing screening. A saliva specimen was obtained prior to discharge in 187 infants (93.5% of those who failed UNHS). In 178 infants saliva testing was performed at ≤21 days of chronological age and yielded results. cCMV infection was identified in 4/178 tested infants (2.25%, 95% CI 0.8% to 5.3%), of whom three were diagnosed with SNHL (1.7%, 95% CI 0.5% to 4.4%) and offered antiviral treatment. Two of the tested infants (1.12%, 95% CI 0.2% to 3.6%) were diagnosed with cCMV solely due to failure in UNHS. Occult central nervous system (CNS) symptoms of cCMV infection were detected in 2/4 infants following targeted investigation.

CONCLUSIONS:

Targeted cCMV screening in newborns who failed UNHS contributed to the early detection of infants born with cCMV-related isolated SNHL or with occult CNS symptoms who could potentially benefit from antiviral treatment.

KEYWORDS:

Cytomegalovirus; Screening; hearing; newborn; saliva

[Indexed for MEDLINE]

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