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Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants

BACKGROUND: Preterm infants are at greater risk of developing postnatal cytomegalovirus (CMV) infection with serious symptoms. Breast milk is the main route of CMV transmission in populations with a high seroprevalence. OBJECTIVES: This study aimed to investigate the clinical presentation and transm...

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Autores principales: Lee, Jun Eon, Han, Yea Seul, Sung, Tae-Jung, Kim, Dong Hyun, Kwak, Byung Ok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719915/
https://www.ncbi.nlm.nih.gov/pubmed/36479291
http://dx.doi.org/10.3389/fped.2022.1022869
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author Lee, Jun Eon
Han, Yea Seul
Sung, Tae-Jung
Kim, Dong Hyun
Kwak, Byung Ok
author_facet Lee, Jun Eon
Han, Yea Seul
Sung, Tae-Jung
Kim, Dong Hyun
Kwak, Byung Ok
author_sort Lee, Jun Eon
collection PubMed
description BACKGROUND: Preterm infants are at greater risk of developing postnatal cytomegalovirus (CMV) infection with serious symptoms. Breast milk is the main route of CMV transmission in populations with a high seroprevalence. OBJECTIVES: This study aimed to investigate the clinical presentation and transmission of postnatal CMV (pCMV) infection via breast milk in preterm infants under the specific setting of our neonatal intensive care unit (NICU). METHODS: The medical records of 147 preterm infants were reviewed retrospectively, and their clinical characteristics and outcomes were analyzed. Breast milk and infant urine samples were collected every two weeks until discharge, and the kinetics of CMV loads were evaluated using a polymerase chain reaction assay. RESULTS: Seventeen infants (11.6%) were diagnosed with pCMV infection during the study period. In comparison between the pCMV and control groups, the mean birth weight was significantly lower in the pCMV group than in the control group (1084.1 ± 404.8 g vs. 1362.5 ± 553.8 g, P = 0.047). Four (23.5%) patients had leukocytopenia, six (35.3%) had neutropenia, three (17.6%) had thrombocytopenia, and two (11.8%) had hyperbilirubinemia in the pCMV group. Five patients were treated with antiviral agents, and their CMV load in the urine decreased after treatment. CMV loads peaked at 3–5 weeks in breast milk, whereas they peaked at 8–12 weeks of postnatal age in infants' urine. A comparison between the median CMV load in breast milk from the pCMV and control groups revealed a significant difference (P = 0.043). CONCLUSION: Most preterm infants with pCMV infection present a favorable clinical course and outcomes. A high CMV viral load in breast milk is associated with transmission. Further studies are warranted to prevent transmission and severe pCMV infections in preterm infants.
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spelling pubmed-97199152022-12-06 Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants Lee, Jun Eon Han, Yea Seul Sung, Tae-Jung Kim, Dong Hyun Kwak, Byung Ok Front Pediatr Pediatrics BACKGROUND: Preterm infants are at greater risk of developing postnatal cytomegalovirus (CMV) infection with serious symptoms. Breast milk is the main route of CMV transmission in populations with a high seroprevalence. OBJECTIVES: This study aimed to investigate the clinical presentation and transmission of postnatal CMV (pCMV) infection via breast milk in preterm infants under the specific setting of our neonatal intensive care unit (NICU). METHODS: The medical records of 147 preterm infants were reviewed retrospectively, and their clinical characteristics and outcomes were analyzed. Breast milk and infant urine samples were collected every two weeks until discharge, and the kinetics of CMV loads were evaluated using a polymerase chain reaction assay. RESULTS: Seventeen infants (11.6%) were diagnosed with pCMV infection during the study period. In comparison between the pCMV and control groups, the mean birth weight was significantly lower in the pCMV group than in the control group (1084.1 ± 404.8 g vs. 1362.5 ± 553.8 g, P = 0.047). Four (23.5%) patients had leukocytopenia, six (35.3%) had neutropenia, three (17.6%) had thrombocytopenia, and two (11.8%) had hyperbilirubinemia in the pCMV group. Five patients were treated with antiviral agents, and their CMV load in the urine decreased after treatment. CMV loads peaked at 3–5 weeks in breast milk, whereas they peaked at 8–12 weeks of postnatal age in infants' urine. A comparison between the median CMV load in breast milk from the pCMV and control groups revealed a significant difference (P = 0.043). CONCLUSION: Most preterm infants with pCMV infection present a favorable clinical course and outcomes. A high CMV viral load in breast milk is associated with transmission. Further studies are warranted to prevent transmission and severe pCMV infections in preterm infants. Frontiers Media S.A. 2022-11-21 /pmc/articles/PMC9719915/ /pubmed/36479291 http://dx.doi.org/10.3389/fped.2022.1022869 Text en © 2022 Lee, Han, Sung, Kim and Kwak. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Lee, Jun Eon
Han, Yea Seul
Sung, Tae-Jung
Kim, Dong Hyun
Kwak, Byung Ok
Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants
title Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants
title_full Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants
title_fullStr Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants
title_full_unstemmed Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants
title_short Clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants
title_sort clinical presentation and transmission of postnatal cytomegalovirus infection in preterm infants
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719915/
https://www.ncbi.nlm.nih.gov/pubmed/36479291
http://dx.doi.org/10.3389/fped.2022.1022869
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