Outcomes from an Expanded Targeted Early Cytomegalovirus Testing Program

Objective This study aimed to determine the outcomes from an expanded targeted early congenital cytomegalovirus (cCMV) testing program. Study Design A retrospective analysis of data was collected from June 2016 to April 2018 of patients who underwent expanded targeted early cCMV testing during the peri-implementation phase. Information regarding patient presentation, test type/result, and audiologic outcomes were collected. Chi-square and two-samplet-tests were performed. Results A total of 754 patients underwent cCMV testing; during that period there were 56,947 births at 20 different hospitals. Reasons for completing cCMV testing included the following: (1) failed hearing screening (35.8%), (2) intrauterine growth restriction (IUGR) or small for gestational age (SGA) (29.1%), (3) sepsis (10.7%), (4) other/unknown (8.7%), (5) elevated liver enzymes or bilirubin (5.1%), (6) thrombocytopenia (5.1%), (7) central nervous system abnormalities (3.3%), and (8) mother with suspected cCMV infection (2.2%). The most frequent type of cCMV test performed was urine polymerase chain reaction (75.8%). A total of 21 (2.8%) patients tested positive for cCMV, of which 12 (57%) were symptomatic. This value represents a prevalence of 36.9 cCMV cases and 21.1 symptomatic cCMV cases diagnosed per 100,000 live births. Criteria most commonly associated with a positive testing were failed hearing screening (33.3%), IUGR/SGA (28.6%), and a mother with suspected cCMV infection (19.0%). Conclusion Implementation of an expanded targeted early CMV testing program has the potential to identify symptomatic cCMV infants who would not be identified otherwise.