Real-time PCR-based testing of saliva for cytomegalovirus at birth
Real-time PCR-based testing of saliva for cytomegalovirus at birth
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DOI：
10.1586/eri.11.130
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发表时间：
2011-12-01
影响因子：
5.7
通讯作者：
Brogan, Thomas V.
中科院分区：
文献类型：
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作者：
Belec, Laurent;Brogan, Thomas V.
评估：Boppana SB、Ross SA、Shimamura M 等人。用于新生儿巨细胞病毒筛查的唾液聚合酶链反应测定。 N. 英格兰。 J. Med。 364, 2111-2118 (2011)。巨细胞病毒 (CMV) 通常引起先天性感染。因此，CMV 是非遗传性感觉神经性听力损失的一个重要病因。然而，由于在生命早期没有症状，围产期和婴儿早期的筛查检查未能识别出大多数有巨细胞病毒引起的听力损失风险的儿童。此外，先天性巨细胞病毒感染的普遍筛查尚未实施。目前，新生儿通过快速唾液培养进行测试，但这种测试的大规模自动化将很困难。幸运的是，已经创建了更新的潜在替代测试。一项重要的进步包括使用液体或干燥唾液样本通过 PCR 方法对新生儿进行检测。在一项大规模、前瞻性、多机构研究中，将两种类型的唾液样本与唾液培养的金标准进行了比较。在接受检测的 34,989 名新生儿中，0.5%（即 177 名样本）CMV 检测呈阳性。当针对 CMV 培养物进行测量时，液体和干燥唾液的测试均具有敏感性 (>97%) 和特异性 (>98%)。干燥唾液的 PCR 检测具有适应新生儿先天性 CMV 感染普遍筛查的潜在益处。在提出对新生儿巨细胞病毒感染进行普遍筛查作为一项有价值的公共卫生策略之前，需要仔细评估早期发现、干预和治疗临床上不明显病例的优势。
Evaluation of: Boppana SB, Ross SA, Shimamura M et al. Saliva polymerase-chain-reaction assay for cytomegalovirus screening in newborns. N. Engl. J. Med. 364, 2111-2118 (2011).Cytomegalovirus (CMV) commonly causes congenital infection. As such, CMV is a prominent etiology for nongenetic sensori-neural hearing loss. However, screening examination in the perinatal and early infant period fails to identify most children at risk for CMV-produced hearing loss because of the absence of symptoms early in life. Furthermore, generalized screening for congenital CMV infection has yet to be implemented. Currently, newborns are tested via means of a rapid saliva culture but large-scale automation of this test would be difficult. Fortunately, newer potential replacement tests have been created. An important advance includes testing newborns via means of PCR using liquid or dried saliva samples. In a large-scale, prospective, multi-institutional study both types of salivary samples were compared with the gold standard of saliva culture. Of the 34,989 neonates tested, 0.5% or 177 samples tested positive for CMV. Testing of both liquid and dried saliva were sensitive (>97%) as well as specific (>98%) when measured against CMV culture. PCR testing of dried saliva has the potential benefit of adapting to generalized screening of neonates for congenital CMV infection. The advantages of early detection, intervention for and treatment of cases that are not clinically apparent needs to be carefully evaluated before proposing universal newborn screening for CMV infection as a valuable public health strategy.