Unraveling the Mystery of Congenital CMV: Raising Awareness, Streamlining Screening, and Diasorin’s Liaison MDx

Imagine a stealthy, devastating infection that affects newborns, resulting in hearing loss, cognitive deficits, and other disabilities. This is the reality of congenital cytomegalovirus (CMV) infection, a significant public health concern that often remains under the radar (1). As a physician, laboratory technologist, or advocate for child health, it is crucial to understand congenital CMV and the importance of testing. In this article, we will delve into the world of congenital CMV, discussing its clinical manifestations, epidemiology, screening strategies, and current testing techniques.

A Comprehensive Overview of Congenital CMV Testing Techniques:

In the pursuit of identifying and managing congenital CMV, various testing techniques have been developed. Polymerase Chain Reaction (PCR) assays are a preferred choice, offering high sensitivity and specificity when testing newborns' urine or saliva within the first two to three weeks of life (2). Viral cultures, a more traditional method, are less sensitive and more time-consuming. Serological tests, while useful in detecting CMV-specific antibodies in the blood, are not ideal for newborns due to the potential presence of maternal antibodies (3). Meanwhile, antigenemia assays and nucleic acid testing (NAT) methods such as transcription-mediated amplification (TMA) and loop-mediated isothermal amplification (LAMP) provide additional options for detecting and quantifying CMV nucleic acids in various samples (4).

Screening Strategies and the Imperative need for Awareness:

There are two primary approaches to newborn screening for congenital CMV: targeted and universal. Targeted screening focuses on infants exhibiting risk factors or symptoms, while universal screening tests all newborns (5). However, awareness of congenital CMV remains limited among healthcare professionals and the general public, leading to missed opportunities for early diagnosis and intervention (6). Raising awareness is critical for enhancing long-term outcomes for affected children and streamlining screening strategies.

Challenges of Testing for Congenital CMV:

Laboratories conducting congenital CMV tests face numerous challenges, which need to be addressed to ensure accurate and efficient testing. These challenges include proper sample collection and handling of newborn samples such as urine, saliva, or blood, which is critical to avoid false-negative or false-positive results due to contamination, inadequate sample volume, or delays in processing (2). Furthermore, congenital CMV testing methods must offer high sensitivity and specificity to minimize the risk of misdiagnosis or delayed treatment; however, not all testing techniques currently meet these criteria (3). Another critical factor is the turnaround time, as rapid results are essential for early intervention and management of congenital CMV infections, yet some traditional testing methods, such as viral cultures, can be time-consuming (4). Limited awareness and education among healthcare professionals and laboratory staff about congenital CMV, its implications, and the importance of testing can lead to suboptimal screening practices, delayed diagnosis, and inadequate management of affected infants (6). Lastly, the cost-effectiveness of implementing universal or targeted screening programs for congenital CMV poses a challenge, as striking a balance between the benefits of early detection and intervention and the financial implications for healthcare systems is not always straightforward (8).

Introducing Biorus' Revolutionary Solution:

Recognizing the need for innovation in congenital CMV testing, Biorus proudly presents the Liaison MDx system from Diasorin Molecular. This sample-to-answer system revolutionizes CMV testing by providing rapid results in just 70 minutes, empowering healthcare providers to make informed decisions regarding diagnosis and treatment more efficiently than ever before (7).

The story of congenital CMV is one that warrants attention. By raising awareness, refining screening strategies, and utilizing advanced testing techniques, we can reshape the narrative and improve long-term outcomes for affected infants. Addressing the challenges faced by laboratories, such as sample collection and handling, sensitivity and specificity, turnaround time, limited awareness and education, and cost-effectiveness, is essential to enhance the accuracy and efficiency of congenital CMV testing. Biorus is dedicated to leading the charge with advanced solutions like the Liaison MDx system, paving the way for a brighter future for countless newborns and their families. Join us in this mission by sharing this article, disseminating the information, and supporting innovations in congenital CMV testing.

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References:

1.??????Kenneson, A., & Cannon, M. J. (2007). Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Reviews in Medical Virology, 17(4), 253-276. [https://onlinelibrary.wiley.com/doi/10.1002/rmv.535]

2.??????Lazzarotto, T., Guerra, B., Gabrielli, L., Lanari, M., & Landini, M. P. (2011). Update on the prevention, diagnosis, and management of cytomegalovirus infection during pregnancy. Clinical Microbiology Reviews, 24(3), 497-514. [https://pubmed.ncbi.nlm.nih.gov/21631642/]

3.??????Boppana, S. B., Ross, S. A., & Fowler, K. B. (2013). Congenital cytomegalovirus infection: clinical outcome. Clinical Infectious Diseases, 57(Supplement_4), S178-S181. [https://pubmed.ncbi.nlm.nih.gov/24257422/]

4.??????Gaytant, M. A., Steegers, E. A., Semmekrot, B. A., Merkus, H. M., & Galama, J. M. (2002). Congenital cytomegalovirus infection: review of the epidemiology and outcome. Obstetrical & Gynecological Survey, 57(4), 245-256. [https://pubmed.ncbi.nlm.nih.gov/11961482/]

5.??????Fowler, K. B., & Boppana, S. B. (2018). Congenital cytomegalovirus (CMV) infection and hearing deficit. Journal of Clinical Virology, 102, 69-72. [https://pubmed.ncbi.nlm.nih.gov/16386462/]

6.??????Korver, A. M., de Vries, J. J., de Jong, J. W., Dekker, F. W., Vossen, A. C., Oudesluys-Murphy, A. M (2017). Awareness of congenital cytomegalovirus among doctors in the Netherlands. Journal of Clinical Virology, 95, 48-53. [https://pubmed.ncbi.nlm.nih.gov/19818680/]

7.??????Diagnostics, Diasorin. (n.d.). LIAISON? MDX. Retrieved from [https://molecular.diasorin.com/us/liaison-mdx/]

8.??????Gantt, S., Dionne, F., Kozak, F. K., Goshen, O., Goldfarb, D. M., Park, A. H., Fowler, K., & Boppana, S. B. (2016). Cost-effectiveness of Universal and Targeted Newborn Screening for Congenital Cytomegalovirus Infection. JAMA Pediatrics, 170(12), 1173-1180. [https://pubmed.ncbi.nlm.nih.gov/27723885/]