Characterization of a universal screening approach for congenital CMV infection based on a highly-sensitive, quantitative, multiplex real-time PCR assay

English version

Autoři: Angela Nagel ^aff001; Emmanouela Dimitrakopoulou ^aff002; Norbert Teig ^aff003; Peter Kern ^aff004; Thomas Lücke ^aff003; Dariusz Michna ^aff005; Klaus Korn ^aff001; Philipp Steininger ^aff001; Khalid Shahada ^aff006; Katrin Neumann ^aff002; Klaus Überla ^aff001
Působiště autorů: Institute of Clinical and Molecular Virology, University Hospital Erlangen, Erlangen, Germany ^aff001; Department of Otorhinolaryngology, Head and Neck Surgery, Division of Phoniatrics and Pediatric Audiology, St. Elisabeth-Hospital, Ruhr University Bochum, Bochum, Germany ^aff002; Department of Pediatrics, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany ^aff003; Department of Gynecology, St. Elisabeth-Hospital, Ruhr University Bochum, Bochum, Germany ^aff004; Department of Pediatrics, Elisabeth-Hospital Essen, Germany ^aff005; Audiology and Balance Center, Hamad Medical Corporation, Doha, Qatar ^aff006
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227143

Souhrn

The majority of congenital cytomegalovirus (cCMV) infections are asymptomatic at birth and therefore not diagnosed. Approximately 10–15% of these infants develop late-onset hearing loss and other developmental disorders. Implementation of a universal screening approach at birth may allow early initiation of symptomatic interventions due to a closer follow-up of infants at risk and offers the opportunity to consider treatment of late-onset disease. Real-time PCR assays for the detection of CMV DNA in buccal swab samples demonstrated feasibility and good clinical sensitivity in comparison to a rapid culture screening assay. Because most cCMV infections remain asymptomatic, a universal screening assay that stratifies CMV infected infants according to low and high risk of late-onset cCMV disease could limit the parental anxiety and reduce follow-up costs. We therefore developed and characterized a screening algorithm based on a highly-sensitive quantitative real-time PCR assay that is compatible with centralized testing of samples from universal screening and allows to determine CMV DNA load of saliva samples either as International Units (IU)/ml saliva or IU/10⁵ cell equivalents. 18 of 34 saliva samples of newborns that tested positively by the screening algorithm were confirmed by detection of CMV DNA in blood and/or urine samples obtained during the first weeks of life. All screening samples that could not be confirmed had viral loads of <2.3x10⁵ IU/ml saliva (median: 6.8x10³) or 1.3x10⁵ IU/10⁵ cell equivalents (median: 4.0x10²). The viral load of screening samples with confirmed cCMV infection ranged from 7.5x10² to 8.2x10⁹ IU/ml saliva (median: 9.3x10⁷) or 1.5x10² to 5.6x10¹⁰ IU/10⁵ cell equivalents (median: 3.5x10⁶). Clinical follow-up of these newborns with confirmed cCMV infection should reveal whether the risk of late-onset cCMV disease correlates with CMV DNA load in early life saliva samples and whether a cut-off can be defined identifying cCMV infected infants with or without risk for late-onset cCMV disease.

Klíčová slova:

Albumins – Blood – DNA extraction – Neonates – Polymerase chain reaction – Saliva – Urine – Viral load

Zdroje

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Characterization of a universal screening approach for congenital CMV infection based on a highly-sensitive, quantitative, multiplex real-time PCR assay

Souhrn

Klíčová slova:

Zdroje

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