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

Nagel A, Dimitrakopoulou E, Teig N, Kern P, Lücke T, Michna D, Korn K, Steininger P, Shahada K, Neumann K, Überla K (2020)

Publication Type: Journal article

Publication year: 2020

Journal

PLoS ONE Public Library of Science

Book Volume: 15

Pages Range: e0227143-

Journal Issue: 1

DOI: 10.1371/journal.pone.0227143

Abstract

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.

Authors with CRIS profile

Philipp Steininger Institute of Clinical and Molecular Virology Klaus Überla Lehrstuhl für Klinische und Molekulare Virologie

Involved external institutions

Katholisches Klinikum Bochum (St. Josef- und St. Elisabeth-Hospital gGmbH) DE Germany (DE) Elisabeth-Krankenhaus Essen DE Germany (DE) Hamad Medical Corporation QA Qatar (QA)

How to cite

APA:

Nagel, A., Dimitrakopoulou, E., Teig, N., Kern, P., Lücke, T., Michna, D.,... Überla, K. (2020). Characterization of a universal screening approach for congenital CMV infection based on a highly-sensitive, quantitative, multiplex real-time PCR assay. PLoS ONE, 15(1), e0227143-. https://doi.org/10.1371/journal.pone.0227143

MLA:

Nagel, Angela, et al. "Characterization of a universal screening approach for congenital CMV infection based on a highly-sensitive, quantitative, multiplex real-time PCR assay." PLoS ONE 15.1 (2020): e0227143-.

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