Diagnosis of congenital cytomegalovirus infection by detection of viral DNA in urine pools

Paixão, Paulo; Almeida, Sofia; Gouveia, Paula; Binda, Sandro; Caroppo, Simona; Barbi, Maria

doi:10.1016/j.jviromet.2005.02.018

Cited by 18 publications

(15 citation statements)

References 14 publications

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“…In a previous study [14], a pool method for newborn urine specimens was tested with a nested-PCR technique. The aim of that study was to demonstrate that the principle used in blood banking, pool testing [1], could be applied to the diagnosis of HCMV congenital infection.…”

Section: Introductionmentioning

confidence: 99%

Screening of congenital cytomegalovirus infection by real-time PCR in urine pools

Paixão

Almeida

Videira³

et al. 2011

Eur J Pediatr

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Human cytomegalovirus (HCMV) is the most frequent cause of congenital infection. Despite the fact that 5-17% of asymptomatic infected babies will develop late sequelae and, therefore, should be closely followed, most of these children will remain undetected, as screening of all newborns by viral culture is too expensive and no valid alternative has been widely accepted. The aim of this work was to demonstrate that pool testing can be used to screen HCMV congenital infection in newborns. For this purpose, a real-time PCR technique was tested in urine pools. This pool method was applied to all urine specimens from children received in the virology laboratory of the Centro Hospitalar Cova da Beira for diagnosis of HCMV infection for a period of 14 months. Ten out of the 160 urine samples were tested positive by shell-vial culture and were also detected by this pool method. Additionally, 100 urine specimens, collected in 2004 and culture negative for HCMV were included to test the specificity of this methodology, all of which were negative. In conclusion, these results suggest that urine pools can be used to detect HCMV-positive urines in children, with similar sensitivity and specificity when compared with the standard method. Because of the very significant reduction both in terms of labour and cost of testing materials, this methodology may represent a valid option for screening the HCMV congenital infection in newborns.

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Section: Introductionmentioning

confidence: 99%

Screening of congenital cytomegalovirus infection by real-time PCR in urine pools

Paixão

Almeida

Videira³

et al. 2011

Eur J Pediatr

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“…A good example is pooling samples for the detection of blood-borne viruses, which has been used successfully for a decade in transfusion or non-transfusion settings [Allain, 2000;Roth et al, 2002;Mine et al, 2003;Stramer et al, 2004;Seme et al, 2011]. It has been demonstrated recently that urine pools can be used for PCR-based screening of congenital CMV infection without influencing the sensitivity [Paixã o et al, 2005[Paixã o et al, , 2011. Previous studies and our limited experience indicate that median CMV viral loads detected in urine samples from newborns with congenital CMV infection were high enough to allow pooling of at least 24 urine samples without compromising sensitivity [Pass et al, 1983;Boppana et al, 2005;Yan et al, 2008;Cannon et al, 2011].…”

Section: Discussionmentioning

confidence: 99%

“…Conventional virus isolation from urine or saliva is still considered the ''gold standard'' for identification of newborns with congenital CMV infection, but the method is laborious, not amenable to automation and thus unsuitable for large-scale screening [Schleiss, 2008;Syggelou et al, 2010]. Molecular methods, such as the polymerase chain reaction (PCR), are considered currently to be the most appropriate methods for CMV screening of the newborn [Schlesinger et al, 2003;Paixã o et al, 2005;Barbi et al, 2006;Boppana et al, 2010]. However, due to the diverse results obtained in recent major screening studies, the question of which clinical sample saliva, urine or dried blood spots (DBS), is best suited for large-scale neonatal CMV screening is still matter of intense debate [Dollard and Schleiss, 2010;Kharrazi et al, 2010;de Vries et al, 2010;Boppana et al, 2011;Cannon et al, 2011;Leruez-Ville et al, 2011].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of congenital cytomegalovirus infection in Slovenia: A study on 2,841 newborns

Paradiž

Seme

Puklavec

et al. 2011

Journal of Medical Virology

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Human cytomegalovirus (CMV) is the most frequent cause of congenital infection in humans. In the first prevalence study of congenital CMV infection in Eastern and Central Europe, all neonates born in a 22-month period in two Slovenian maternity units (total of 2,841 newborns) were screened prospectively for congenital CMV infection by a real-time polymerase chain reaction (PCR) in urine. In all newborns with positive screening results, plasma and dried blood spots (DBS) collected at birth were tested additionally for CMV DNA. Congenital CMV infection was confirmed by virus isolation from a urine sample collected within the first 2 weeks of life. Congenital CMV infection was identified in four out of 2,841 newborns tested (incidence 0.14%; 95% CI, 0.05-0.39%). In four newborns with confirmed congenital infection, the concentration of CMV DNA in urine ranged from 4.68 to 8.18 log(10) copies/ml, all four newborns had detectable CMV DNA in plasma taken at birth (1.26-3.34 log(10) copies/ml) and two out of four had detectable CMV DNA in DBS collected during newborn metabolic screening. None of the four newborns with confirmed congenital CMV infection was symptomatic. The study showed that the prevalence of congenital CMV infection at birth in Slovenia is among the lowest in the world and that CMV DNA PCR testing of urine is a suitable and affordable real-time screening strategy for congenital CMV infection. If it is performed in 24 mini-pools, the cost of screening is 1.4 €/newborn and the cost of detecting a single newborn with congenital CMV infection 1,000 €.

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“…The typical clinical symptoms of congenital CMV infection that are found in infected neonates include intrauterine growth retardation, microcephaly with intracranial calcification, hepatosplenomegaly, jaundice, chorioretinitis, thrombocytopenic purpura and anemia [1,2].…”

Section: Introductionmentioning

confidence: 99%

Is low birth weight a risk indicator for congenital cytomegalovirus infection?

Al-Hareth

Monem

Megiud

2009

J Infect Dev Ctries

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Background: Congenital cytomegalovirus infection is currently the leading cause of congenital infection in 0.2-2.2% of live births worldwide leading to variable serious sequalae. The aim of the study was to determine if low birth weight is an indicator of CMV congenital infection evidenced by detecting CMV-DNA in umbilical cord blood at the time of delivery. Methodology: CMV-IgG and IgM antibodies and CMV-DNAemia were assessed in umbilical cord blood of two hundreds newborns, one hundred of whom had birth weight ≤ 2700 gram and/or head circumference ≤ 32 cm. Results: CMV-IgM was not detected, while CMV-IgG was positive in 80-90% of the two hundreds tested newborns. CMV-DNA was detected in four out of the 200 newborns. One of them was over the adopted weight limit (> 2700 gram). Conclusions: CMV-IgM and IgG antibodies assessment was not a potential discriminative test to identify congenitally infected newborns. In addition, low birth weight and small head circumference at birth failed to predict congenital CMV infection. CMV-DNA detection in umbilical cord blood at the time of delivery using real-time PCR of all newborns is recommended as decisive, rapid and non-invasive test.

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Diagnosis of congenital cytomegalovirus infection by detection of viral DNA in urine pools

Cited by 18 publications

References 14 publications

Screening of congenital cytomegalovirus infection by real-time PCR in urine pools

Screening of congenital cytomegalovirus infection by real-time PCR in urine pools

Prevalence of congenital cytomegalovirus infection in Slovenia: A study on 2,841 newborns

Is low birth weight a risk indicator for congenital cytomegalovirus infection?

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