title: Newborn screening for congenital cytomegalovirus using real-time polymerase chain reaction in umbilical cord blood.
abstract: BACKGROUND
  Congenital cytomegalovirus (C-CMV) infection affects 0.4-2% of newborn infants in Israel, most of whom are asymptomatic. Of these, 10-20% will subsequently develop hearing impairment and may have benetitted from early detection by neonatal screeing.
  
  
  OBJECTIVE
  To retrospectively anaIyze the results of a screening program for C-CMV performed at the Sheba Medical Center, Tel, Hashomer, during a 1 year period, using real-time polymerase chain reaction (rt-PCR) from umbilical cord blood.
  
  
  METHODS
  CMV DNA was detected by rt-PCR performed on infants' cord blood. C-CMV was confirmed by urine culture (Shell-vial). All confirmed cases were further investigated for C-CMV manifestations by head ultrasound, complete blood count, liver enzyme measurement, ophthalmology examination and hearing investigation.
  
  
  RESULTS
  During the period 1 June 2009 to 31 May 2010, 11,022 infants were born at the Sheba Medical Center, of whom 8105 (74%) were screened. Twenty-three (0.28%) were positive for CMV and 22 of them (96%) were confirmed by urine culture. Two additional infants, who had not been screened, were detected after clinical suspicion. All 24 infants were further Investigated, and 3 (12.5%) had central nervous system involvement (including hearing impairment) and were offered intravenous ganciclovir for 6 weeks. Eighteen infants (82%) would not otherwise have been diagnosed.
  
  
  CONCLUSIONS
  The relatively low incidence of C-CMV detected in our screening program probably reflects the low sensitivity of cord blood screening. Nevertheless, this screening program reliably detected a non-negligible number of infants who could benefit from early detection. Other screening methods using saliva should be investigated further.
authors.affiliation: Pediatric Infectious Diseases Unit, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel. galia.barkai@sheba.health.gov.il
authors.forename: Galia
authors.initials: G
authors.lastname: Barkai
authors.forename: Asher
authors.initials: A
authors.lastname: Barzilai
authors.forename: Ella
authors.initials: E
authors.lastname: Mendelson
authors.forename: Michal
authors.initials: M
authors.lastname: Tepperberg-Oikawa
authors.forename: Daphne Ari-Even
authors.initials: DA
authors.lastname: Roth
authors.forename: Jacob
authors.initials: J
authors.lastname: Kuint
mesh_terms: D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D004279:DNA, Viral; D042241:Early Diagnosis; D005260:Female; D005312:Fetal Blood / Q000821:virology*; D034381:Hearing Loss / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012680:Sensitivity and Specificity; D014556:Urine / Q000821:virology
chemical_list: D004279:DNA, Viral