The latest study published in the Acta Otorrinolaringológica Española raises concerns regarding the inefficacy of current practices around the screening for congenital cytomegalovirus (CMVc) infection following failed universal hearing tests in neonates. Conducted in a secondary hospital setting, the study underscores the pitfalls of procedural delays, specifically pointing out deficiencies in attending to non-resident newborns.
Abstract
The research, headed by Marco Sabater and colleagues, pinpoints selective screening for CMVc as an overlooked but critical opportunity in cases of altered hearing screenings. Sabater, along with his Valencia-based team, suggests integrating CMVc testing into the neonatal hearing screening program to catch early infections, particularly for infants who do not pass initial hearing screenings.
DOI Details
DOI: 10.1016/j.otoeng.2023.07.004
Article Number: S2173-5735(24)00010-3
Publishing Date: January 12, 2024
Study Findings
The study revealed that during the observed period, CMVc screenings, especially for newborns birthed outside the hospital where screenings were conducted, were grossly delayed. In the limited instances where screenings were performed, only a mere 30% met the advised timeframe.
Solution Forward
The proposed remedy is a recalibration of the screening protocol timeline, allowing CMVc testing through saliva or urine within the first 21 days post-birth. Additionally, the recommendation urges for better-equipped screening programs inclusive of ample staff and resources for efficient implementation.
The Importance of Early CMVc Detection
Congenital CMV is a pervasive cause of sensorineural hearing loss in infants. Early detection is paramount, as some of the CMV-related hearing deficits may be mitigated or managed more effectively with timely intervention.
Challenges and Hurdles
Crucial to the discourse is the need to understand the identified barriers. These range from logistical issues such as inadequate staffing, lack of streamlined protocols for non-resident births, to delays in the ordering and execution of necessary screenings.
Literature Review
The interdisciplinary review within suggests that selective screening for CMVc following failed newborn hearing tests can significantly benefit early detection and management. Yet, it stipulates the need for system-wide changes to facilitate these processes.
Comprehensive Response
The call for action includes a checklist that encompasses earlier screenings, adaptive measures for babies born off-site, and resource allocation that ensures all newborns gain equal access to these critical early intervention services.
Study Authors
Authors include Marco Sabater, Ana A., José Miguel JM Sequi Sabater, Marta M. Gómez Delgado, Alberto A. Lora Martín, Víctor V. Aparisi Climent, and José Miguel JM Sequi Canet, all esteemed professionals in pediatric and health research with affiliations to respected Spanish institutions such as the Hospital Universitario Francesc de Borja and the Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO).
References
1. Rawlinson, W. D., Boppana, S. B., Fowler, K. B., Kimberlin, D. W., Lazzarotto, T., Alain, S., … & Leruez-Ville, M. (2017). Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. The Lancet Infectious Diseases, 17(6), e177-e188.
2. Dollard, S. C., Grosse, S. D., & Ross, D. S. (2007). New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Reviews in Medical Virology, 17(5), 355-363.
3. Fowler, K. B., McCollister, F. P., Dahle, A. J., Boppana, S., Britt, W. J., & Pass, R. F. (1997). Progressive and fluctuating sensorineural hearing loss in children with asymptomatic congenital cytomegalovirus infection. The Journal of Pediatrics, 130(4), 624-630.
4. Boppana, S. B., Ross, S. A., & Fowler, K. B. (2013). Congenital cytomegalovirus infection: clinical outcome. Clinical Infectious Diseases, 57(suppl_4), S178-S181.
5. Cannon, M. J., Hyde, T. B., & Schmid, D. S. (2011). Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection. Reviews in Medical Virology, 21(4), 202-213.
Keywords
1. Congenital CMV Screening
2. Neonatal Hearing Loss
3. CMVc Infection in Infants
4. Universal Hearing Screening Protocols
5. Newborn CMV Detection Methods
In conclusion, the study proposes a revamp of current screening practices to prevent missed opportunities in diagnosing CMVc-linked hearing loss, advocating for coalesced efforts between hospital administration, healthcare providers, and policy makers. The goal is streamlined, inclusive, and prompt screening modalities to safeguard the auditory health of the youngest in society.
