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Direct Saliva Real-time Polymerase Chain Reaction Assay Shows Low Birth Prevalence of Congenital Cytomegalovirus Infection in Urban Western India

Viswanathan, Rajlakshmi, MD*; Bafna, Sanjay, MD; Mergu, Ravikanth, MBBS; Deshpande, Gururajrao, PhD*; Gunjikar, Rashmi, MSc*; Gaikwad, Shivshankar, BSc*; Mullick, Jayati, PhD

The Pediatric Infectious Disease Journal: April 2019 - Volume 38 - Issue 4 - p e65–e68
doi: 10.1097/INF.0000000000002094
Maternal-Neonatal Reports

Background: Congenital cytomegalovirus (cCMV) infection is the leading infectious cause of mental retardation, developmental delay and sensorineural deafness. Nonprimary infection plays a major role in transmission of this infection in countries with high maternal seroprevalence. Noninvasive sampling and testing is a useful alternative to traditional methods of laboratory detection of congenital CMV infection. The present study was conducted to understand birth prevalence of cCMV infection using molecular techniques, in an urban setting of a developing country with evidence of high maternal seroprevalence.

Methods: Universal newborn screening for cCMV was performed for 750 infants born at a tertiary care center in Western India. Real-time polymerase chain reaction was directly carried out on saliva samples. Follow-up laboratory testing of saliva, urine and blood was performed for neonates identified as positive. Sequential clinical follow-up was offered to the affected infants.

Results: A birth prevalence of 0.4% (95% CI: 0.13–1.2) was observed with 3 of 750 babies confirmed to be positive for cCMV infection. All 3 babies were born to seropositive mothers (anti-CMV immunoglobulin G positive). One of the babies detected was symptomatic with sepsis like features. All of them survived and did not develop any sequelae up to 1 year of age.

Conclusion: The use of direct real-time polymerase chain reaction of saliva samples can be considered as a feasible option for newborn screening of congenital CMV infection in developing countries. Relatively low birth prevalence of cCMV infection was observed in our study, which needs to be corroborated through further studies.

From the *Diagnostic Virology Group, ICMR-National Institute of Virology, Pune, India

Department of Pediatric Medicine, Jehangir Hospital, Pune, India

Avian Influenza Group, ICMR-National Institute of Virology, Pune, India.

Accepted for publication April 2, 2018.

Supported by ICMR-National Institute of Virology, Pune.

The authors have no conflicts of interest to disclose.

Planning and development of study, supervision of laboratory testing, data analysis, and writing manuscript draft (R.V.); clinical coordination, patient assessment, and follow up: (S.B.); collection of samples and data, initial clinical evaluation (R.M.); standardization of laboratory tests: GD&RG, performed laboratory tests: GD&SAG, development of molecular assays and revision of manuscript (J.M.). All authors read and approved the final draft of the manuscript.

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Address for correspondence: Rajlakshmi Viswanathan, MD, ICMR-National Institute of Virology, Microbial Containment Complex, 130/1, Sus Road, Pune 411021, Maharashtra, India. E-mail:;

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