title: Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss.
abstract: To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL).
  
  
  
  Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL.
  
  
  
  DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL.
  
  
  
  DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life.
authors.affiliation: Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL; Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Shannon A
authors.initials: SA
authors.lastname: Ross
authors.affiliation: Department of Pediatrics, Carolinas Medical Center, Charlotte, NC.
authors.forename: Amina
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS.
authors.forename: April L
authors.initials: AL
authors.lastname: Palmer
authors.affiliation: Department of Pediatrics, University of Pittsburgh and the Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
authors.forename: Marian G
authors.initials: MG
authors.lastname: Michaels
authors.affiliation: Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, OH.
authors.forename: Pablo J
authors.initials: PJ
authors.lastname: Sánchez
authors.affiliation: Department of Pediatrics, University of Texas Southwestern Medical School, Dallas, TX.
authors.forename: Audra
authors.initials: A
authors.lastname: Stewart
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH.
authors.forename: David I
authors.initials: DI
authors.lastname: Bernstein
authors.affiliation: Saint Peter's University Hospital, New Brunswick, NJ.
authors.forename: Kristina
authors.initials: K
authors.lastname: Feja
authors.affiliation: Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL; Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Fowler
authors.affiliation: Department of Pediatrics, The University of Alabama at Birmingham, Birmingham, AL; Department of Microbiology, The University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Suresh B
authors.initials: SB
authors.lastname: Boppana
mesh_terms: D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000097:blood / Q000151:congenital* / Q000175:diagnosis*; D059788:Dried Blood Spot Testing; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D018570:Risk Assessment
keywords: cytomegalovirus; dried blood spot; hearing loss