115. Results of a Targeted Neonatal Screening Program for Congenital Cytomegalovirus Infection in Montreal, Quebec

BACKGROUND: There remains considerable debate on the role of symptomatic, targeted vs. universal screening of newborns for congenital cytomegalovirus infection (cCMV). Here we report on a hospital-based targeted screening program for (1) infants who failed their newborn hearing screen and (2) infants of HIV-infected women, and compare this to the prevalence among infants tested for CMV following clinical suspicion of a congenital infection. METHODS: In November 2013, the “Programme québécois de dépistage de la surdité chez les nouveau-nés” (PQDSN), a provincially mandated hearing screening program, was implemented at Centre Hospitalier Universitaire Sainte-Justine, a tertiary maternal-child health center in Montreal, Quebec, along with CMV screening for all infants who failed their hearing test (excluding patients in the neonatal intensive care unit). Concurrently, beginning in April 2013, all infants of HIV-infected women were screened for cCMV infection within 48 hours of birth. The birth prevalence of cCMV infection in these targeted populations was compared with the prevalence among newborns tested for a clinical suspicion of cCMV. RESULTS: Out of 11 734 newborns screened for hearing through the PQDSN program between April 2014 and March 2018, 536 failed their initial hearing screen and 4 of these newborns tested positive for cCMV infection (0.75%). Out of a total of 130 HIV-exposed newborns born during this period, 116 were screened for cCMV and 3 (2.6%) confirmed positive. An additional 455 newborns were identified by the attending pediatrician as having a risk factor for any congenital infection; of these, 22 (5.3%) tested positive for cCMV. Using these combined methods, a total of 0.24% of newborns enrolled in the PQDSN program tested positive for cCMV infection. CONCLUSION: The overall birth prevalence of cCMV was 0.75% among infants who failed their hearing screen, 2.6% among HIV exposed newborns, and 5.3% among infants with a clinical suspicion of a congenital infection. In the absence of a universal screening program for newborns, these results reinforce the importance of maintaining a high index of clinical suspicion for cCMV infection. DISCLOSURES: All authors: No reported disclosures.