Breast Milk and Saliva for Postnatal Cyto†megalovirus Screening among Very Low Birth Weight Infants.
Breast Milk and Saliva for Postnatal Cyto†megalovirus Screening among Very Low Birth Weight Infants.
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母乳和唾液用于极低出生体重婴儿产后巨细胞病毒筛查。
DOI：
10.1097/inf.0000000000003671
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Puopolo,KarenM
中科院分区：
文献类型：
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作者：
Mukhopadhyay,Sagori;Itell,HannahL;Hartman,Erica;Woodford,Emily;Dhudasia,MirenB;Steppe,JustinT;Valencia,Sarah;Roark,Hunter;Wade,KellyC;Weimer,KristinED;Permar,SallieR;Puopolo,KarenM
背景：在极低出生体重儿（VLBW）中管理出生后巨细胞病毒病（pCMV）的最佳方法仍然未知。目的：确定母乳和婴儿唾液是否可用于可靠地识别母体巨细胞病毒（CMV）血清状态和检测婴儿pCMV获得。方法：这是一项针对2017年至2020年出生的极低出生体重婴儿及其母亲的单中心前瞻性队列研究。使用CMV糖蛋白B结合酶联免疫吸附试验检测母乳样品中的CMV免疫球蛋白G（IgG），并将结果与母体血清CMV IgG结果进行比较。每两周一次，从CMV血清状态阳性或未知的母亲所生的婴儿中收集配对的唾液和尿液样本。唾液样本进行了测试CMV DNA的定量实时聚合酶链反应（PCR），并与尿CMV定性PCR结果从临床laborator.Results：在108名婴儿没有先天性CMV纳入研究，10（9%）收购pCMV。70名母亲的乳汁和血液CMV血清学结果均可用。母乳抗体检测在确定CMV血清状态方面的敏感性为97.2%（95%CI：85.5 - 99.9%），特异性为91.2%（95%CI：76.3 - 98.1%）。配对连续收集唾液和尿液样本（n = 203），66名婴儿。唾液PCR检测pCMV感染的敏感性为30.0%（95%CI：6.7-65.2%），特异性为92.7%（95%CI：88.1-96.0%）。婴儿唾液的系列测试对于识别早产儿中的pCMV获得没有足够的灵敏度。
Background:The optimal approach to managing postnatal cytomegalovirus disease (pCMV) among very low birth weight (VLBW) infants remains unknown. Methods to facilitate screening are needed.Objective:Determine whether mother’s milk and infant saliva can be used to reliably identify maternal cytomegalovirus (CMV) serostatus and detect infant pCMV acquisition.Methods:This was a single-center, prospective cohort study of VLBW infants, and their mothers, born between 2017 and 2020. Maternal milk samples were tested for CMV immunoglobulin G (IgG) using a CMV glycoprotein B binding enzyme-linked immunosorbent assay and the results were compared with maternal serum CMV IgG results. Biweekly paired saliva and urine samples were collected from infants born to mothers with positive or unknown CMV serostatus. Saliva samples were tested for CMV DNA by quantitative real-time polymerase chain reaction (PCR) and compared with urine CMV qualitative PCR results obtained from a clinical laboratory.Results:Among 108 infants without congenital CMV included in the study, 10 (9%) acquired pCMV. Both milk and blood CMV serology results were available for 70 mothers. Maternal milk antibody testing had a sensitivity of 97.2%(95% CI: 85.5–99.9%) and specificity of 91.2%(95% CI: 76.3–98.1%) in establishing CMV serostatus. Paired serially collected saliva and urine samples (n= 203) were available for 66 infants. Saliva PCR had a sensitivity of 30.0%(95% CI: 6.7–65.2%) and specificity of 92.7%(95% CI: 88.1–96.0%) in detecting pCMV acquisition.Conclusions:Maternal breast milk is a reliable alternative sample to determine CMV serostatus. Serial testing of infant saliva was not adequately sensitive for identifying pCMV acquisition in preterm infants.