新生儿巨细胞病毒筛查:这是新标准吗?

IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY
Soren Gantt
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引用次数: 0

摘要

综述目的:先天性巨细胞病毒感染(cCMV)是儿童听力损失和神经发育迟缓的主要原因。cCMV的早期识别有助于改善结果的干预措施,特别是对儿童早期出现的与cCMV相关的听力损失。大多数cCMV在出生时没有症状,很少在没有新生儿筛查的情况下被诊断出来。因此,cCMV筛查的各种方法越来越多地被采用。最近的发现:cCMV的普遍筛查(对所有新生儿进行检测)和定向筛查(由听力筛查失败引发的检测)似乎都是有价值、可行和成本效益的,尽管普遍筛查被预测具有最大的潜在总体益处。新生儿口腔拭子的CMV PCR检测是敏感和实用的,因此被广泛用于有针对性的筛查项目。相比之下,使用干血点(DBS)的PCR不太敏感,但被当前普遍的cCMV筛查计划所采用,因为DBS已经从高收入国家的所有新生儿中收集,这避开了大规模的口腔拭子收集。摘要:有针对性的筛查被广泛推荐为护理标准,而普遍筛查则不太常见,但逐渐被认为是识别cCMV儿童的最佳策略。与所有筛查项目一样,cCMV筛查需要承诺公平可靠的检测、随访和服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Newborn cytomegalovirus screening: is this the new standard?

Purpose of review: Congenital cytomegalovirus infection (cCMV) is a major cause of childhood hearing loss and neurodevelopmental delay. Early identification of cCMV allows for interventions that improve outcomes, particularly for cCMV-related hearing loss that develops in early childhood. Most cCMV is asymptomatic at birth and is rarely diagnosed without newborn screening. Therefore, various approaches to cCMV screening are increasingly being adopted.

Recent findings: Both universal screening (testing all newborns) and targeted screening (testing triggered by failed hearing screening) for cCMV appear valuable, feasible and cost-effective, though universal screening is predicted to have greatest potential overall benefits. CMV PCR testing of newborn oral swabs is sensitive and practical and is therefore widely used in targeted screening programs. In contrast, PCR using dried-blood spots (DBS) is less sensitive but was adopted by current universal cCMV screening initiatives because DBS are already collected from all newborns in high-income countries, which circumvents large-scale oral swab collection.

Summary: Targeted screening is widely recommended as standard of care, while universal screening is less common but is progressively considered as the optimal strategy for identification of children with cCMV. As with all screening programs, cCMV screening requires commitments to equitable and reliable testing, follow-up and services.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
96
审稿时长
6-12 weeks
期刊介绍: Current Opinion in Otolaryngology & Head and Neck Surgery is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With eleven disciplines published across the year – including maxillofacial surgery, head and neck oncology and speech therapy and rehabilitation – every issue also contains annotated references detailing the merits of the most important papers.
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