Saliva pools for screening of human cytomegalovirus using real-time PCR

Eur J Pediatr. 2021 Apr;180(4):1067-1072. doi: 10.1007/s00431-020-03842-x. Epub 2020 Oct 14.

Abstract

Human cytomegalovirus (HCMV) is the leading congenital infection agent in the world. The importance of screening this infection has been debated, as 10-15% of the asymptomatic newborns with HCMV at birth will present late sequelae. The aim of this study was to test the feasibility of using saliva pools from newborns in a screening program for congenital HCMV infection, in two Portuguese hospitals. The screening was based on the use of pools of 10 saliva samples for detection of viral DNA by real-time PCR. Whenever there was a positive pool, the samples were tested individually, and for each positive sample the result was confirmed with a urine sample collected in the first 2 weeks of life. The study involved 1492 newborns. One hundred and fifty pools were screened, with 14 positive results in saliva, but only 10 were confirmed in urine samples, giving a prevalence of congenital HCMV infection in both hospitals of 0.67% (CI95% 0.36 to 1.23%).Conclusion: The overall prevalence of congenital HCMV infection in both hospitals was 0.67%. The use of saliva pools proved to be effective for the screening of this congenital infection, allowing timely screening and confirmation in a large population, with associated cost reduction. What is Known: • Newborn screening for HCMV is desirable. • Saliva is a good and practical sample. What is New: • The feasibility of using saliva pools for a large-scale screening. • The cost reduction of this strategy.

Keywords: Cost reduction; HCMV; Newborn; Pools.

MeSH terms

  • Cytomegalovirus Infections* / diagnosis
  • Cytomegalovirus Infections* / epidemiology
  • Cytomegalovirus* / genetics
  • DNA, Viral
  • Female
  • Humans
  • Infant, Newborn
  • Neonatal Screening
  • Real-Time Polymerase Chain Reaction
  • Saliva

Substances

  • DNA, Viral