HCMV

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。人巨细胞病毒（HCMV）是疱疹病毒组的成员。在HCMV血清阳性的妇女中，潜伏的HCMV感染重新激活，随后进入母乳。从母乳中分离出HCMV的比率根据母乳的类型、检测频率和病毒分离方法而有所不同。在0.6%至13%的初乳样本中检测到HCMV; 32%至96%的血清阳性妇女的成熟乳汁样本含有HCMV。从母乳样本中分离HCMV的实验室分离耗时，技术困难且不标准化。目前，对于有兴趣喂养早产儿、低出生体重儿的医生来说，没有方法可以确保母乳中没有传染性HCMV。 HCMV感染的传播将发生在37%至69%的早产儿母乳喂养的HCMV血清阳性母亲。母乳喂养的早产儿中有症状的HCMV感染的频率尚未令人信服地确定。在报告的文献中，未纳入适当的控制措施，并忽略了共存的细菌病原体。缺乏一个标准的政策，治疗挤出的母乳进一步复杂化的研究HCMV感染早产儿，低出生体重儿。 本研究将检测母乳喂养的早产低出生体重儿的HCMV感染。本研究分为两部分，针对出生体重小于1500 g或妊娠32周前分娩的婴儿进行不同的研究设计。对于研究的横断面部分，主要终点是一年或一年前尿HCMV脱落的患病率。对于该研究的前瞻性观察部分，主要终点是喂食新鲜冷冻、挤出的母乳的早产、低出生体重婴儿的HCMV传播率。将检查次要终点，以比较喂养其自身HCMV血清阳性母亲新鲜冷冻母乳的早产低出生体重婴儿的临床病程与喂养其自身HCMV血清阴性母亲母乳的婴儿的临床病程。对于两个研究部分，将检查以下次要终点：1）记录的感染，2）呼吸支持和3）抗菌药物使用。预计患者总数包括230名婴儿和230名母亲，共计460人。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Human cytomegalovirus (HCMV) is a member of the herpes virus group. In HCMV seropositive women, reactivation of latent HCMV infection occurs with subsequent shedding into breast milk. The rate of HCMV isolation from breast milk varies according to the type of milk, frequency of testing, and methods of viral isolation. HCMV is detected in 0.6% to 13% of colostrum specimens; 32% to 96% of mature milk samples from seropositive women contain HCMV. Laboratory isolation of HCMV from breast milk samples is time-consuming, technically difficult and not standardized. Currently, for physicians interested in feeding premature, low birth weight infants their own mother's expressed breast milk, there is no method to assure breast milk is free of infectious HCMV. Transmission of HCMV infection will occur in 37% to 69% of preterm infants fed breast milk from HCMV seropositive mothers. The frequency of symptomatic HCMV infection in preterm infants fed maternal breast milk has not been established convincingly. In the reported literature, appropriate controls have not been included and co-existing bacterial pathogens have been disregarded. Lack of a standard policy for treatment of expressed breast milk further complicates research on HCMV infection in preterm, low birth weight infants. This study will examine HCMV infection in preterm, low birth weight infants fed maternal breast milk. This study is divided into two parts with different study designs for infants with birth weights less than 1500 grams or delivered before 32 weeks gestation. For the cross-sectional part of the study, the primary endpoint is the prevalence of urine HCMV shedding as or before one year. For the prospective observational part of the study, the primary endpoint is the incidence of HCMV transmission to premature, low birth weight infants fed fresh frozen, expressed maternal breast milk. Secondary endpoints will be examined in order to permit the comparison of the clinical course of premature low birth weight infants fed their own HCMV seropositive mother's fresh frozen breast milk to the clinical course of infants fed their own HCMV seronegative mother's breast milk. For both study parts, the following secondary endpoints will be examined: 1) documented infections, 2) respiratory support, and 3) antimicrobial usage. Total patients expected include 230 infants and 230 mothers for a total of 460.