Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns
Abstract Background Cytomegalovirus (CMV) is one of the most important pathogens associated with congenital infection worldwide. Most congenital CMV-infected infants are asymptomatic at birth; however, some can develop delayed sequelae, especially hearing loss. Methods This study aimed to investigat...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Virology Journal |
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| Online Access: | https://doi.org/10.1186/s12985-024-02324-y |
| _version_ | 1827321594591051776 |
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| author | Lauro Juliano Marin Pérola Rodrigues dos Santos Felipe Charu Ramos Uener Ribeiro dos Santos Marcílio Marques Luciana Debortoli de Carvalho Sandra Rocha Gadelha Victor Hugo Aquino |
| author_facet | Lauro Juliano Marin Pérola Rodrigues dos Santos Felipe Charu Ramos Uener Ribeiro dos Santos Marcílio Marques Luciana Debortoli de Carvalho Sandra Rocha Gadelha Victor Hugo Aquino |
| author_sort | Lauro Juliano Marin |
| collection | DOAJ |
| description | Abstract Background Cytomegalovirus (CMV) is one of the most important pathogens associated with congenital infection worldwide. Most congenital CMV-infected infants are asymptomatic at birth; however, some can develop delayed sequelae, especially hearing loss. Methods This study aimed to investigate the prevalence of congenital CMV infection in a neonatal intensive care unit in a low-income region of Brazil. The objectives extended to identifying associated factors, assessing the clinical status of infected newborns, and undertaking a two-year follow-up to discern potential long-term consequences in the affected infants. This cross-sectional prospective study enrolled newborns up to three weeks of life requiring intensive medical care. We employed a convenience sampling method to include 498 newborns and 477 mothers in the study. Categorical variables underwent analysis employing Fisher’s exact test, whereas the examination of continuous variables involved the Mann‒Whitney test. Results CMV DNA was detected in saliva/urine samples from 6 newborns (1.21%), confirming congenital infection. We noted a significantly greater incidence (OR: 11.48; 95% CI: 2.519–52.33; p = 0.0094) of congenital infection among twins (7.14%) than among nontwins (0.66%). The twin patients exhibited discordant infection statuses, suggesting that only one of the babies tested positive for CMV. Most of the infected children were born to mothers who initiated sexual activity at a younger age (p = 0.0269). Only three out of the six newborns diagnosed with CMV infection underwent comprehensive clinical assessments and received continuous follow-up until they reached two years of age. Only one of the children had weight and height measurements below the norm for their age, coupled with developmental delays. Conclusions The prevalence of congenital CMV infection among newborns admitted to the NICU was low and similar to that in the general population. However, we found a significantly greater incidence of congenital CMV infection in twins than in singletons. Interestingly, the twin-infected patients exhibited discordant infection statuses, suggesting that CMV was present in only one of the babies. We also found that most of the infected children were born to mothers who initiated sexual activity at a younger age. Diagnostic accessibility and comprehensive surveillance programs are imperative for effectively managing and preventing congenital CMV infections. |
| first_indexed | 2024-04-25T01:08:55Z |
| format | Article |
| id | doaj.art-fbd489928b0f4624ae7e9ea376817178 |
| institution | Directory Open Access Journal |
| issn | 1743-422X |
| language | English |
| last_indexed | 2024-04-25T01:08:55Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Virology Journal |
| spelling | doaj.art-fbd489928b0f4624ae7e9ea3768171782024-03-10T12:05:47ZengBMCVirology Journal1743-422X2024-03-0121111010.1186/s12985-024-02324-yCongenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newbornsLauro Juliano Marin0Pérola Rodrigues dos Santos1Felipe Charu Ramos2Uener Ribeiro dos Santos3Marcílio Marques4Luciana Debortoli de Carvalho5Sandra Rocha Gadelha6Victor Hugo Aquino7Laboratório de Farmacogenômica e Epidemiologia Molec ular, Departamento de Ciências da Saúde, Universidade Estadual de Santa CruzLaboratório de Farmacogenômica e Epidemiologia Molec ular, Departamento de Ciências da Saúde, Universidade Estadual de Santa CruzFaculdade de Medicina, Departamento de Ciências da Saúde, Universidade Estadual de Santa CruzLaboratório de Imunobiologia, Departamento de Ciências Biológicas, Universidade Estadual de Santa CruzFaculdade de Medicina, Departamento de Ciências da Saúde, Universidade Estadual de Santa CruzLaboratório de Microbiologia, Departamento de Ciências Biológicas, Universidade Estadual de Santa CruzLaboratório de Farmacogenômica e Epidemiologia Molec ular, Departamento de Ciências da Saúde, Universidade Estadual de Santa CruzDepartamento de Inmunología, Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de AsunciónAbstract Background Cytomegalovirus (CMV) is one of the most important pathogens associated with congenital infection worldwide. Most congenital CMV-infected infants are asymptomatic at birth; however, some can develop delayed sequelae, especially hearing loss. Methods This study aimed to investigate the prevalence of congenital CMV infection in a neonatal intensive care unit in a low-income region of Brazil. The objectives extended to identifying associated factors, assessing the clinical status of infected newborns, and undertaking a two-year follow-up to discern potential long-term consequences in the affected infants. This cross-sectional prospective study enrolled newborns up to three weeks of life requiring intensive medical care. We employed a convenience sampling method to include 498 newborns and 477 mothers in the study. Categorical variables underwent analysis employing Fisher’s exact test, whereas the examination of continuous variables involved the Mann‒Whitney test. Results CMV DNA was detected in saliva/urine samples from 6 newborns (1.21%), confirming congenital infection. We noted a significantly greater incidence (OR: 11.48; 95% CI: 2.519–52.33; p = 0.0094) of congenital infection among twins (7.14%) than among nontwins (0.66%). The twin patients exhibited discordant infection statuses, suggesting that only one of the babies tested positive for CMV. Most of the infected children were born to mothers who initiated sexual activity at a younger age (p = 0.0269). Only three out of the six newborns diagnosed with CMV infection underwent comprehensive clinical assessments and received continuous follow-up until they reached two years of age. Only one of the children had weight and height measurements below the norm for their age, coupled with developmental delays. Conclusions The prevalence of congenital CMV infection among newborns admitted to the NICU was low and similar to that in the general population. However, we found a significantly greater incidence of congenital CMV infection in twins than in singletons. Interestingly, the twin-infected patients exhibited discordant infection statuses, suggesting that CMV was present in only one of the babies. We also found that most of the infected children were born to mothers who initiated sexual activity at a younger age. Diagnostic accessibility and comprehensive surveillance programs are imperative for effectively managing and preventing congenital CMV infections.https://doi.org/10.1186/s12985-024-02324-yCytomegalovirusCongenital infectionNewbornNeonatal intensive care unit |
| spellingShingle | Lauro Juliano Marin Pérola Rodrigues dos Santos Felipe Charu Ramos Uener Ribeiro dos Santos Marcílio Marques Luciana Debortoli de Carvalho Sandra Rocha Gadelha Victor Hugo Aquino Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns Virology Journal Cytomegalovirus Congenital infection Newborn Neonatal intensive care unit |
| title | Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns |
| title_full | Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns |
| title_fullStr | Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns |
| title_full_unstemmed | Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns |
| title_short | Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns |
| title_sort | congenital cmv infection in a brazilian neonatal intensive care unit high prevalence among twin newborns |
| topic | Cytomegalovirus Congenital infection Newborn Neonatal intensive care unit |
| url | https://doi.org/10.1186/s12985-024-02324-y |
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