Development of a nappy for the detection of Cytomegalovirus (CMV) in the urine of neonates

先天性巨细胞病毒（CMV）感染发生在子宫内病毒从母亲传播给胎儿。在英国，估计每200个婴儿中就有1-4个婴儿出生时患有先天性CMV，这是非遗传性感觉神经听力损失的最常见原因。十分之一的先天性巨细胞病毒新生儿在出生时会有症状，包括：肝肿大，血小板减少，心脏缺陷和颅内钙化。其余的新生儿将无症状，但其中10%将发展为长期后遗症，其中最常见的是感觉神经听力损失。在英国，目前的护理标准是考虑在出生后第一个月内治疗患有先天性CMV和神经系统症状（包括听力损失）的新生儿。因此，及时诊断对于不错过治疗窗口至关重要。由于新生儿通常在出生后不久就出院，因此快速检测可以在出院前轻松识别感染，从而在医院进行进一步的调查。目前的CMV检测使用聚合酶链反应（PCR）来分析有症状新生儿的体液，可能需要1-3天，并且错过了90%的（无症状）感染新生儿。如果能够开发出一种廉价且简单易用的检测方法，它将彻底改变我们检测先天性CMV感染的方式，使每个新生儿都能接受筛查。随着越来越多的证据积累，无症状的新生儿和婴儿的治疗，巨细胞病毒可能会被添加到新生儿筛查计划，但目前的诊断方法可能是成本高昂。

Congenital cytomegalovirus (CMV) infection occurs following in-utero transmission of virus from mother to foetus. In the UK it is estimated that 1-4 babies in every 200 will be born with congenital CMV, which is the most common cause of non-genetic sensory neural hearing loss. One in ten neonates with congenital CMV will have symptoms at birth including: hepatosplemomegally, thrombocytopaenia, heart defects and intracranial calcification. The remainder of neonates will be asymptomatic but of these, 10% will develop long-term sequelae, the most common of which is sensory neural hearing loss. In the UK, the current standard of care is to consider treatment of neonates with congenital CMV and neurological symptoms (which includes hearing loss) within the first month of life. Prompt diagnosis is therefore essential for the window of treatment not to be missed. As neonates are typically discharged soon after birth, a rapid test would enable infection to be easily identified before discharge, enabling further investigations to be carried out in hospital.Current tests for CMV use polymerase chain reaction (PCR) to analyse bodily fluids of symptomatic neonates, which can take 1-3 days and misses 90% of (asymptomatic) infected newborns. If a cheap and simple to use assay can be developed, it will revolutionise how we detect congenital CMV infections, allowing every neonate to be screened. As more evidence accumulates for the treatment of asymptomatic neonates and infants it is possible that CMV may be added to the newborn screening programme but the current methods of diagnosis may be cost-prohibitive.