title: Mixed infection and strain diversity in congenital cytomegalovirus infection.
abstract: BACKGROUND
  Cytomegalovirus (CMV), the most common cause of congenital infection, exhibits extensive genetic variability. We sought to determine whether multiple CMV strains can be transmitted to the fetus and to describe the distribution of genotypes in the saliva, urine, and blood.
  
  
  METHODS
  Study subjects consisted of a convenience sampling of 28 infants found to be CMV-positive on newborn screening as part of an ongoing study. Genotyping was performed on saliva specimens obtained during newborn screening and urine, saliva, and blood obtained at a later time point within the first 3 weeks of life.
  
  
  RESULTS
  Six (21.4%) of the 28 saliva samples obtained within the first 2 days of life contained >1 CMV genotype. Multiple CMV genotypes were found in 39% (5/13) of urine, saliva, and blood samples obtained within the first 3 weeks of life from 13 of the 28 newborns. There was no predominance of a CMV genotype at a specific site; however, 4 infants demonstrated distinct CMV strains in different compartments.
  
  
  CONCLUSIONS
  Infection with multiple CMV strains occurs in infants with congenital CMV infection. The impact of intrauterine infection with multiple virus strains on the pathogenesis and long-term outcome remains to be elucidated.
authors: Department of Pediatrics, University of Alabama, Birmingham, AL 35233, USA. sross@peds.uab.edu
authors: Shannon A
authors: SA
authors: Ross
authors: Zdenek
authors: Z
authors: Novak
authors: Sunil
authors: S
authors: Pati
authors: Raj Kumar
authors: RK
authors: Patro
authors: Jennifer
authors: J
authors: Blumenthal
authors: Vishwanath R
authors: VR
authors: Danthuluri
authors: Amina
authors: A
authors: Ahmed
authors: Marian G
authors: MG
authors: Michaels
authors: Pablo J
authors: PJ
authors: Sánchez
authors: David I
authors: DI
authors: Bernstein
authors: Robert W
authors: RW
authors: Tolan
authors: April L
authors: AL
authors: Palmer
authors: William J
authors: WJ
authors: Britt
authors: Karen B
authors: KB
authors: Fowler
authors: Suresh B
authors: SB
authors: Boppana
mesh_terms: D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000151:congenital / Q000652:urine / Q000821:virology*; D005260:Female; D005838:Genotype; D006023:Glycoproteins / Q000097:blood / Q000235:genetics / Q000652:urine; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D012463:Saliva / Q000821:virology*
chemical_list: D006023:Glycoproteins