Methods: Retrospective review of the electronic health records of all infants admitted to the Level 4 outborn NICU at Nationwide Children’s Hospital, Columbus, OH from 8/2016-5/2017. Demographic and clinical data were obtained, and the age that the first hearing screen was performed was assessed.
Results: During the 10 month study period, 362 infants were admitted to the NICU and had a first hearing screen performed. The majority of neonates (204, 56%) had a first hearing screen performed in the first 3 weeks of age. However, 158 (44%; median birth weight [IQR], 1072 g [747-1766]; median gestational age [IQR], 28 weeks [25-32]) infants received the first hearing screen at >3 weeks of age when a positive CMV PCR or culture cannot distinguish congenital infection from intrapartum/postnatal acquisition of CMV. Of the 158 infants, 20 (13%) did not pass the first hearing screen (13, unilateral; 7, bilateral), and subsequently, 9 of them did pass a second hearing screen. However, 11 of the 20 infants did not pass a second hearing screen and had urine CMV PCR testing, and 1 (9%) was positive. This latter infant’s newborn dried blood spot CMV DNA PCR was negative so a diagnosis of congenital CMV infection was not possible.
Conclusion: Targeted screening in the NICU for CMV-related hearing loss is problematic as a substantial number of infants do not have a hearing screen performed until after 21 days of age, thus representing a missed opportunity for diagnosis of congenital CMV infection and institution of antiviral therapy if indicated. Our findings support universal CMV screening of neonates on admission to the NICU.
M. Shimamura, None
G. Hounam, None
U. Findlen, None
P. Wozniak, None
N. Foor, None
O. Adunka, MED-EL Corporation: Consultant , Consulting fee , Educational grant and Research support
Advanced Bionics: Consultant , Consulting fee and Licensing agreement or royalty
Advanced Cochlear Diagnostics: President , Ownership interest
AGTC Corporation: Consultant , Consulting fee
P. J. Sanchez, None