Pediatric Otolaryngology

Analysis of an Expanded Targeted Early Cytomegalovirus Testing Program

Suarez D, Nielson C, McVicar SB, et al. Analysis of an Expanded Targeted Early Cytomegalovirus Testing Program [published online ahead of print, 2023 Mar 8]. Otolaryngol Head Neck Surg. 2023 [Article Link]

Is an expanded targeted testing program effective at detecting congenital cytomegalovirus?

Congenital cytomegalovirus (cCMV) is the most common congenital infection worldwide. While early detection of symptomatic cCMV results in quicker implementation of therapy and better outcomes, there is not a standardized method of cCMV screening across the United States. This retrospective study analyzed an expanded targeted early cCMV testing program from March 2021 to August 2022 where 3,450 (8.8%) of 39,425 live births underwent urine cCMV PCR testing due to one of several indications for targeted screening including but not limited to: maternal CMV, central nervous system abnormalities, microcephaly, intrauterine growth restriction, and failed newborn hearing screen. The study authors found the prevalence of symptomatic cCMV cases diagnosed with the expanded targeted early testing program was 35.7 per 100,000 live births, compared to 30 per 100,000 live births if a universal program was utilized, and 12.7 per 100,000 live births if only a hearing-targeted testing approach was utilized. The most common indication for testing was small for gestational age (68.2%) and macrocephaly (13.6%) while the most common indication for testing in CMV positive patients (n=14) was small for gestational age (n=11, 68.8%) and abnormal hearing test (n=2, 12.5%). The expanded targeted early testing program was described as very feasible to implement and significantly cheaper than universal testing.

Kevin Chacko’s Takeaway: This expanded targeted early cCMV testing program may be more effective at detecting symptomatic cCMV compared to both a hearing-targeted screening and universal screening. Further research analyzing the implementation of this program in other institutions will help demonstrate its generalizability to other healthcare systems in the United States.