Newborn Screening for Congenital Cytomegalovirus Infection in Iran

To the Editor: The prevalence of cytomegalovirus (CMV) infection at birth is between 0.6% and 0.7% in developed countries and between 1% and 5% in developing countries and 10% to 15% infected infants are symptomatic.1,2 It is necessary to establish newborn congenital CMV detection screening for proper management of congenital CMV cases. We established a congenital CMV screening of urine specimens from 2000 newborns to evaluate the congenital CMV infection in Gorgan, South east of Caspian Sea, Iran. Two thousand urine samples of newborns within first 3 weeks of birth were collected randomly and census. All neonates were examined clinically by a certified pediatrician based on the standard procedure. Amplification of CMV DNA in urine sample was performed. Thirteen of the 2000 newborns were CMV positive. Mean age of the newborns at testing was 4.88 ± 4.67 days. The prevalence of congenital CMV infection in this study was thus 0.65%. There were 1208 born at term and 789 premature. One thousand two hundred eighty three were males (64.15%) and 717 females (35.85%). Icterus (602), sepsis (392) and prematurity (374) were the main reasons for hospitalization. Of the 13 infants with positive samples 10 were males and 3 were females. There was significant association between CMV DNA-positivity and height of infants (P = 0.02; Table, Supplemental Digital Content 1, https://links.lww.com/INF/C506). Eleven of the newborns with congenital CMV infection were asymptomatic, whereas 2 showed symptoms such as hepatomegaly, splenomegaly, microcephaly, thrombocytopenia and congenital eye defects (see Table, Supplemental Digital Content 1, https://links.lww.com/INF/C506). The results of clinical and additional assays performed on thirteen neonates with confirmed congenital CMV infection are summarized in Table, Supplemental Digital Content 1, https://links.lww.com/INF/C506. ACKNOWLEDGMENTS The authors’ thank clinical colleagues and staff of Taleghani hospital for newborn recruitment and management. The authors thank Infectious diseases Research Center, Golestan University of Medical Sciences for the continuous encouragement during this study. Naeme Javid, MSc Fatemeh Cheraghali, MD Abdolvahab Moradi, PhD Mishar Kelishadi, MSc Alijan Tabarraei, PhD Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran