Saliva PCR for cytomegalovirus screening in newborns

January 01, 0001

Saliva PCR for cytomegalovirus screening in newborns

Congenital cytomegalovirus (CMV) infection is an important cause of hearing loss, and most infants at risk for CMV-associated hearing loss are not identified early in life. The standard assay for newborn CMV screening is rapid culture performed on saliva specimens. Two alternatives — real-time polymerase-chain-reaction (PCR)-based testing of a liquid-saliva or dried- saliva specimen obtained at birth may be more useful because they can be automated. In this prospective multicenter screening study of newborns, the US authors compared real-time PCR assays of liquid-saliva and dried-saliva specimens with rapid culture of saliva specimens obtained at birth.

They found: "A total of 177 of 34,989 infants (0.5%) were positive for CMV, according to at least one of the three methods. Of 17,662 newborns screened with the use of the liquid-saliva PCR assay, 17,569 were negative for CMV, and the remaining 85 infants (0.5%;) had positive results on both culture and PCR assay. The sensitivity and specificity of the liquid-saliva PCR assay were 100% and 99.9%, and the positive and negative predictive values were 91.4% and 100%, respectively. Of 17,327 newborns screened by means of the dried-saliva PCR assay, 74 were positive for CMV, whereas 76 were found to be CMV-positive on rapid culture. Sensitivity and specificity of the dried-saliva PCR assay were 97.4% and 99.9%, respectively. The positive and negative predictive values were 90.2% and 99.9%, respectively."

The authors concluded: "Real-time PCR assays of both liquid- and dried-saliva specimens showed high sensitivity and specificity for detecting CMV infection and should be considered potential screening tools for CMV in newborns."

The implications of such screening such be fully considered before implementing programs.

For the full abstract, click here.

N Engl J Med 364:2111-2118, 2 June 2011
© 2011 to the Massachusetts Medical Society
Saliva Polymerase-Chain-Reaction Assay for Cytomegalovirus Screening in Newborns. Suresh B. Boppana, Shannon A. Ross, Masako Shimamura, et al. Correspondence to Dr. Bopanna: [email protected]

Category: H. Ear. Keywords: cytomegalovirus, CMV, newborn, screening, deafness, polymerase chain reaction, PCR, diagnostic test study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 14 June 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.