Whitney Wunderlich, Abbey C Sidebottom, Anna K Schulte, Jessica Taghon, Sheila Dollard, Nelmary Hernandez-Alvarado
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引用次数: 0
摘要
在6家医院开展了新生儿干血斑(DBSs)与唾液标本聚合酶链反应(PCR)检测诊断先天性巨细胞病毒(cCMV)的临床敏感性研究。尿检和唾液CMV DNA检测结果均为阳性。几个假阳性(FP)唾液PCR结果的发现促使检查可能与供体牛奶的关联。记录了唾液阳性结果的频率,包括临床确认的真阳性(TP)和FP状态。比较TP和FP病例的供乳使用频率。在2016年至2022年期间测试的22079名参与者中,96人唾液结果呈阳性,15人被确定为FP, 79人被确定为TP, 2人因临床评估不完整而被排除在外。在所有唾液筛查阳性的患者中,有18例(19.14%)使用了新生儿供乳。在15名FPs中,11名(73.33%)消耗了供体奶,而79名tp中有7名(8.8%)(OR 28.29, 95% CI 7.10-112.73, p < 0.001)。虽然牛奶银行持有人巴氏杀菌灭活巨细胞病毒的感染性,巨细胞病毒DNA可能仍然可检测到。由于这种可能的联系,进行唾液巨细胞病毒DNA检测的筛查项目可能会受益于记录供体奶的使用,因为这可能会增加FP结果的风险。
The Use of Saliva Samples to Test for Congenital Cytomegalovirus Infection in Newborns: Examination of False-Positive Samples Associated with Donor Milk Use.
A universal screening research study was conducted in six hospitals to identify the clinical sensitivity of polymerase chain reaction (PCR) testing on newborn dried blood spots (DBSs) versus saliva specimens for the diagnosis of congenital cytomegalovirus (cCMV). CMV DNA positive results from DBSs or saliva were confirmed with urine testing. Findings of several false-positive (FP) saliva PCR results prompted an examination of a possible association with donor milk. Documentation of the frequency of positive saliva results, including both true-positive (TP) and FP status from clinical confirmation, occurred. The frequency of donor milk use was compared for TP and FP cases. Of 22,079 participants tested between 2016 and 2022, 96 had positive saliva results, 15 were determined to be FP, 79 TP, and 2 were excluded for incomplete clinical evaluation. Newborn donor milk use was identified for 18 (19.14%) of all the positive saliva screens. Among the 15 FPs, 11 (73.33%) consumed donor milk compared to 7 of the 79 TPs (8.8%) (OR 28.29, 95% CI 7.10-112.73, p < 0.001). While milk bank Holder pasteurization inactivates CMV infectivity, CMV DNA may still be detectable. Due to this possible association, screening programs that undertake testing saliva for CMV DNA may benefit from documenting donor milk use as a potential increased risk for FP results.