139. Breastfeeding and newborn CMV screening using saliva PCR
Session: Poster Abstract Session: Big Viruses in Little People (Pediatric Viral Diseases)
Thursday, October 27, 2016
Room: Poster Hall
Background: Congenital CMV infection is a leading cause of hearing loss and developmental disabilities. Since most infants with congenital CMV have no clinical abnormalities (asymptomatic) and therefore not recognized, only universal newborn CMV screening will identify all infected infants for monitoring and timely intervention. Real-time PCR of newborn saliva has been shown to be highly sensitive and specific and could be readily adapted for newborn CMV screening. However, it is not known whether breastfeeding will lead to an increased false positive rate in newborns screened for CMV by saliva.

Methods: A prospective study of CMV transmission via breast milk is underway to evaluate the presence of CMV in breast milk in the 6 months post-delivery in young CMV-seropositive women. Colostrum is collected from the mother with the saliva specimens collected from their infants in the first few days post-delivery to evaluate whether CMV in the colostrum or breast milk results in a CMV positive test result in the newborn.

Results: Breast milk and newborn saliva were collected from 172 CMV-seropositive mother and infant pairs and the median sample collection time was 2 days (range, 0-6 days). CMV was detected in 15.7% (27/172) of colostrum specimens. The CMV false positive rate was 0.0% (95% CI, 0.0 – 0.02%) in the infants, as none of the infant saliva samples were positive for CMV. CMV positivity in colostrum was similar in Black, Hispanic white, and non-Hispanic white mothers (p > 0.05). There were no differences between women with CMV positive colostrum/breast milk samples and those with negative samples with respect to age, insurance status or education level. The median viral load in the colostrum was 3.8 x 103 ge/mL (range 100 - 21,000).

Conclusion: The results from this study are similar to the findings from the CHIMES study, where only 23/99,622 (0.02%) newborns screened for CMV by testing saliva were determined to be false-positive because of negative confirmatory urine and/or saliva rapid culture testing. Together, these results suggest that CMV in breast milk in the immediate postpartum period does not influence the results of CMV screening by testing newborn saliva. In addition to the extremely low false positive rate for saliva CMV PCR, the ease of saliva collection in the newborn makes saliva an ideal substrate for universal newborn CMV screening.

Suresh Boppana, MD, FIDSA, FPIDS1, Shannon Ross, MD, MSPH, FIDSA, FPIDS1, Sunil Pati, PhD, MBA1, William J. Britt, M.D.1 and Karen Fowler, DrPH2, (1)Pediatrics, University of Alabama at Birmingham, Birmingham, AL, (2)Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL


S. Boppana, None

S. Ross, None

S. Pati, None

W. J. Britt, None

K. Fowler, None

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