Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss

Shannon A. Ross, Amina Ahmed, April L. Palmer, Marian G. Michaels, Pablo J. Sánchez, Audra Stewart, David I. Bernstein, Kristina Feja, Karen B. Fowler, Suresh B. Boppana

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Study design: Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. Results: DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. Conclusions: DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life.

Original languageEnglish (US)
JournalJournal of Pediatrics
DOIs
StateAccepted/In press - Aug 29 2016

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Sensorineural Hearing Loss
Cytomegalovirus
Newborn Infant
Polymerase Chain Reaction
Sensitivity and Specificity
Cytomegalovirus Infections
Viral Load
Hearing Loss
Saliva
Hearing
Parturition

Keywords

  • Cytomegalovirus
  • Dried blood spot
  • Hearing loss

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss. / Ross, Shannon A.; Ahmed, Amina; Palmer, April L.; Michaels, Marian G.; Sánchez, Pablo J.; Stewart, Audra; Bernstein, David I.; Feja, Kristina; Fowler, Karen B.; Boppana, Suresh B.

In: Journal of Pediatrics, 29.08.2016.

Research output: Contribution to journalArticle

Ross, Shannon A. ; Ahmed, Amina ; Palmer, April L. ; Michaels, Marian G. ; Sánchez, Pablo J. ; Stewart, Audra ; Bernstein, David I. ; Feja, Kristina ; Fowler, Karen B. ; Boppana, Suresh B. / Newborn Dried Blood Spot Polymerase Chain Reaction to Identify Infants with Congenital Cytomegalovirus-Associated Sensorineural Hearing Loss. In: Journal of Pediatrics. 2016.
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abstract = "Objective: To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Study design: Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. Results: DBS at birth was positive in 11 of 26 children (42{\%}) with SNHL at age 4 years and in 72 of 270 children (27{\%}) with normal hearing (P = .11). The sensitivity (42.3{\%}; 95{\%} CI, 23.4{\%}-63.1{\%}) and specificity (73.3{\%}; 95{\%} CI, 67.6{\%}-78.5{\%}) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95{\%} CI, 0.97-2.6) and 0.8 (95{\%} CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. Conclusions: DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life.",
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AU - Ross, Shannon A.

AU - Ahmed, Amina

AU - Palmer, April L.

AU - Michaels, Marian G.

AU - Sánchez, Pablo J.

AU - Stewart, Audra

AU - Bernstein, David I.

AU - Feja, Kristina

AU - Fowler, Karen B.

AU - Boppana, Suresh B.

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N2 - Objective: To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Study design: Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. Results: DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. Conclusions: DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life.

AB - Objective: To determine the utility of dried blood spot (DBS) polymerase chain reaction (PCR) in identifying infants with cytomegalovirus (CMV) infection-associated sensorineural hearing loss (SNHL). Study design: Newborns at 7 US hospitals between March 2007 and March 2012 were screened for CMV by saliva rapid culture and/or PCR. Infected infants were monitored for SNHL during the first 4 years of life to determine sensitivity, specificity, and positive and negative likelihood ratios of DBS PCR for identifying CMV-associated SNHL. Results: DBS at birth was positive in 11 of 26 children (42%) with SNHL at age 4 years and in 72 of 270 children (27%) with normal hearing (P = .11). The sensitivity (42.3%; 95% CI, 23.4%-63.1%) and specificity (73.3%; 95% CI, 67.6%-78.5%) was low for DBS PCR in identifying children with SNHL at age 4 years. The positive and negative likelihood ratios of DBS PCR positivity to detect CMV-associated SNHL at age 4 years were 1.6 (95% CI, 0.97-2.6) and 0.8 (95% CI, 0.6-1.1), respectively. There was no difference in DBS viral loads between children with SNHL and those without SNHL. Conclusions: DBS PCR for CMV has low sensitivity and specificity for identifying infants with CMV-associated hearing loss. These findings, together with previous reports, demonstrate that DBS PCR does not identify either the majority of CMV-infected newborns or those with CMV-associated SNHL early in life.

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KW - Dried blood spot

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