Congenital cytomegalovirus infection in very low birth weight neonates
Keywords:
congenital cytomegalovirus, cytomegalovirus, very low birth weight neonateAbstract
Introduction: Congenital cytomegalovirus infection in neonates weighing less than 1500 grams can be a cause of morbidity, mortality, and disability.
Objective: To describe the behavior of congenital cytomegalovirus infection in a neonatal service.
Methods: A descriptive and cross-sectional study was conducted with 61 neonates. Cytomegalovirus was detected in the first week of life in serum and urine, by polymerase chain reaction, to determine congenital infection. Perinatal variables were evaluated in all neonates, as well as clinical elements and results of complementary examinations in infected infants.
Results: The incidence of congenital infection was 10% (6/61). 5% of the studies were positive (6/122). No urine samples were positive (0/61) and the virus genome was detected in 10% of serum samples (6/61). An association was found between nutritional assessment at birth and cytomegalovirus infection (p < 0.05). A total of 83% of infected neonates had some clinical sign, with respiratory distress syndrome being the most common (67%). In all neonates with congenital infection, brain ultrasound was normal, and retinopathy of prematurity was detected in 33% of patients with fundus retinopathy.
Conclusions: The incidence of congenital cytomegalovirus infection is high in this risk group. The clinical signs found and the results of the fundus in neonates with congenital infection were related to prematurity and the nutritional assessment of hypotrophic was associated with this infection.
Downloads
References
1. American Academy of Pediatrics. Cytomegalovirus Infection. In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH (eds). Red Book:2021. Report of the Committee on Infectious Diseases. Illinois: American Academy of Pediatrics; 2021. p 294-301.
2. Revello MG, Gerna G. Diagnosis and management of Human Cytomegalovirus infection in the mother, fetus and newborn infant. Clin Microbiol Rev. 2002;15(4): 680-715. DOI: 10.1128/CMR.15.4.680-715.2002
3. Ronchi A, Pugni L, Mosca F. Cytomegalovirus Infection. In: Cantey JB (ed). Neonatal Infections. Pathophysiology, Diagnosis, and Management. Texas: Springer; 2018. p. 83-93.
4. Correa CB, Kouri V, Verdasquera D, Martinez PA, Álvarez A, Alemán Y, et al. HCMV seroprevalence and associated risk factors in pregnant women, Havana City, 2007 to 2008. PrenatDiagn. 2010;30:888-92. DOI: 10.1002/pd.2587.
5. Kourí V, Correa CB, Verdasquera D, Martinez PA, Álvarez A, Alemán Y, et al. Diagnosis and Screening for Cytomegalovirus Infection in Pregnant Women in Cuba as Prognostic Markers of Congenital Infection in Newborns: 2007–2008. PediatrInfectDis J 2010;29(12):1105-10. DOI: 10.1097/INF.0b013e3181eb7388
6. Festary A, Kourí V, Correa CB, Verdasquera D, Roig T, Couret MP. Cytomegalovirus and Herpes Simplex Infections in Mothersand Newborns in a Havana Maternity Hospital. MEDICC Review. 2015;17(1):29-34. DOI: 10.37757/MR2015.V17.N1.7
7. Tenorio A, Echevarría JE, Casas I, Echevarría JM, Tabarés E. Detection and typing of human herpesviruses by multiplex polimerase chain reaction. J Virol Methods. 1993; 44:261-9. DOI: 10.1016/0166-0934(93)90061-u
8. Wang S, Wang T, Zhang W, Liu X, Wang X, Wang H, et al. Cohort study on maternal cytomegalovirus seroprevalence and prevalence and clinical manifestations of congenital infection in China. Medicine. 2017;96(5):e6007. DOI: 10.1097/MD.0000000000006007
9. Putri ND, WiyatnoA, Dhenni R, Sriyani IY, Dewantari AK, Handryastuti S, et al. Birth prevalence and characteristics of congenital cytomegalovirus infection in an urban birth cohort, Jakarta, Indonesia . Inter J Infect Dis. 2019;86:31-9. DOI: 10.1016/j.ijid.2019.06.009
10. Lee CY, Lin KY, Chen TH, Sung CH, Yu Ping Fang YP, Sung PL, et al. Prevalence of cytomegalovirus DNAemia and genotypic distribution among childbearing mothers and neonates in Taiwan. Inter J Infect Dis. 2020;91:240-5. DOI: 10.1016/j.ijid.2019.11.025
11. Chuang A, Ramos H, Zelada, López MT, Villavicencio L, Montecinos L, et al. Cribado de infección por citomegalovirus congénito en recién nacidos de alto riesgo. Rev Chilena Infectol. 2021;38(1):45-53. DOI: 10.4067/S0716-10182021000100045
12. Tran C, Bennett MV, Gould JB, Lee HC, Lanzieri TM. Cytomegalovirus Infection among Infants in Neonatal Intensive Care Units, California, 2005–2016. Am J Perinatol. 2020;37(2):146-50. DOI: 10.1055/s-0039-1683958
13. Rawlinson WD, Boppana SB, Fowler KB, Kimberlin DW, Lazzarotto T, Alain S, et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis. 2017;17:e177-88. DOI: 10.1016/S1473-3099(17)30143-3
14. Lin C, Tomio J, Tanaka H, Sonoda M, Sano K,Kobayashi Y. Diagnosis and medical care for congenital cytomegalovirus infection: an observational study using claims data in Japan, 2010–2017. Medicine.2020;99(10):e19419. DOI: 10.1097/MD.0000000000019419.
15. Kobas M Bickle GM, Truttmann AC, Giannoni E, Meylan P, Asner SA. Clinical characteristics, audiological and neurodevelopmental outcomes of newborns with congenital cytomegalovirus infection. Swiss Med Wkly. 2019;149:W20075. DOI: 10.4414/smw.2019.20075
16. Nijman J, Mandemaker FS, Verboon-Maciolek MA, Aitken SC, van Loon AM, et al. Genotype Distribution, Viral Load and Clinical Characteristics of Infants with Postnatal or Congenital Cytomegalovirus Infection. PLoS ONE. 2014;9(9):e108018. DOI: 10.1371/journal.pone.0108018
17. Álvarez Domínguez E, Figueras Aloy J, Botet Mussons F, Marcos Maeso MA, Pérez Fernández JM. Screening for cytomegalovirus infection in very low birth weight infants. An Pediatr (Barc). 2013;79(1):3-9. DOI: 10.1016/j.anpedi.2012.09.018
18. Turner KM, Lee HC, Boppana SB, Carlo WA, Randolph DA. Incidence and impact of CMV infection in very low birth weight infants. Pediatrics. 2014;133(1):e609-15. DOI: 10.1542/peds.2013-2217.
Downloads
Published
How to Cite
Issue
Section
License
Avisos de derechos de autor propuestos por Creative Commons
1. Política propuesta para revistas que ofrecen acceso abierto
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).