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Original article
Contribution of targeted saliva screening for congenital CMV-related hearing loss in newborns who fail hearing screening
  1. Daphne Ari-Even Roth1,2,
  2. Daniel Lubin3,
  3. Jacob Kuint4,5,
  4. Michal Teperberg-Oikawa6,
  5. Ella Mendelson6,7,
  6. Tzipora Strauss5,8,
  7. Galia Barkai5,9
  1. 1Hearing, Speech and Language Center, Chaim Sheba Medical Center, Ramat Gan, Israel
  2. 2Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  3. 3Department of Neonatology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel
  4. 4Maccabi Healthcare Services, Tel Aviv, Israel
  5. 5Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  6. 6Central Virology Laboratory, Israel Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel
  7. 7Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  8. 8Department of Neonatology, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
  9. 9Pediatric Infectious Disease Unit, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel
  1. Correspondence to Dr Daphne Ari-Even Roth, Departmentof Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Chaim Sheba Medical Center, Israel 5262657; rothd{at}post.tau.ac.il

Abstract

Background We previously reported a 2.2% rate of infants born with sensorineural hearing loss (SNHL) due to congenital cytomegalovirus (cCMV) infection identified by universal neonatal screen for cCMV using saliva.

Objective To evaluate the contribution of targeted saliva screening for cCMV to the detection of infants born with cCMV-related SNHL who failed universal newborn hearing screening (UNHS).

Methods We retrospectively reviewed the audiological and medical records of infants who failed UNHS and were tested for cCMV using saliva sample prior to discharge at Sheba Medical Center between 2014 and 2015. Positive cases were confirmed by urine sample.

Results Two hundred (1%) of the 19 830 infants tested during the study period failed in-hospital hearing screening. A saliva specimen was obtained prior to discharge in 187 infants (93.5% of those who failed UNHS). In 178 infants saliva testing was performed at ≤21 days of chronological age and yielded results. cCMV infection was identified in 4/178 tested infants (2.25%, 95% CI 0.8% to 5.3%), of whom three were diagnosed with SNHL (1.7%, 95% CI 0.5% to 4.4%) and offered antiviral treatment. Two of the tested infants (1.12%, 95% CI 0.2% to 3.6%) were diagnosed with cCMV solely due to failure in UNHS. Occult central nervous system (CNS) symptoms of cCMV infection were detected in 2/4 infants following targeted investigation.

Conclusions Targeted cCMV screening in newborns who failed UNHS contributed to the early detection of infants born with cCMV-related isolated SNHL or with occult CNS symptoms who could potentially benefit from antiviral treatment.

  • Cytomegalovirus
  • saliva
  • Screening
  • hearing
  • newborn

https://doi.org/10.1136/archdischild-2016-311859

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    Footnotes

    • Contributors DAER conceptualised and designed the study, including data acquisition and analysis, drafted the initial draft of the manuscript and revised the manuscript. DL made a significant contribution to the conception of the study and revised the manuscript. JK critically revised the draft for important intellectual content and revised the manuscript. MT collected data, participated in the interpretation of the data and revised the manuscript. EM and TS participated in the interpretation of the data and revised the manuscript. GB conceptualised and designed the study, conducted data analysis and revised the manuscript. All authors approved the final submitted manuscript.

    • Competing interests None declared.

    • Ethics approval Institutional review board of the Sheba Medical Center.

    • Provenance and peer review Not commissioned; externally peer reviewed.