HCMV

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 人巨细胞病毒(HCMV)是疱疹病毒群的一员。在HCMV血清阳性的妇女中，潜伏的HCMV感染重新激活，随后脱落到母乳中。从母乳中分离出巨细胞病毒的比率因牛奶类型、检测频率和病毒分离方法而异。在0.6%至13%的初乳样本中检测到巨细胞病毒；32%至96%的血清阳性妇女成熟乳样中含有巨细胞病毒。实验室从母乳样本中分离出巨细胞病毒耗时、技术困难，而且没有标准化。目前，对于有兴趣喂养早产、低出生体重儿的医生来说，他们自己的母亲表达的母乳，没有方法确保母乳中没有传染性的HCMV。 在接受HCMV血清阳性母亲母乳喂养的早产儿中，37%至69%将发生HCMV感染的传播。母乳喂养的早产儿中出现症状的人巨细胞病毒感染的频率还没有令人信服的确定。在已报道的文献中，没有包括适当的控制措施，并忽略了共存的细菌病原体。缺乏治疗母乳的标准政策使早产儿、低出生体重儿的HCMV感染研究进一步复杂化。 这项研究将检测母乳喂养的早产儿、低出生体重儿中的HCMV感染情况。这项研究分为两部分，针对出生体重低于1500克或在怀孕32周前出生的婴儿，采用不同的研究设计。对于这项研究的横断面部分，主要终点是一年前或一年前尿液中HCMV脱落的流行率。对于这项研究的前瞻性观察部分，主要终点是喂养新鲜冷冻、表达的母亲母乳的早产、低出生体重婴儿的HCMV传播发生率。将检查次级终点，以便将喂养自己的HCMV血清阳性的母亲新鲜冷冻母乳的早产低出生体重儿的临床病程与喂养自己的HCMV血清阴性的母亲的母乳的婴儿的临床病程进行比较。对于这两个研究部分，将检查以下次级终点：1)记录在案的感染，2)呼吸支持，3)抗菌药物的使用。预计患者总数包括230名婴儿和230名母亲，总计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 breastmilk. The rate of HCMV isolation from breastmilk 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 breastmilk 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 breastmilk, there is no method to assure breastmilk is free of infectious HCMV. Transmission of HCMV infection will occur in 37% to 69% of preterm infants fed breastmilk 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.