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9/24/2018  |   11:45 AM - 12:15 PM   |  Diamond Ballroom I

Results of a Targeted Screening Program for Congenital Cytomegalovirus Infection in Montreal, Quebec

Background: There remains considerable debate on the role of symptomatic, targeted vs. universal screening for cCMV infection. Here we report on a hospital-based targeted screening program for 1) Infants who failed their newborn hearing screen and 2) Infants of HIV infected mothers, and compare this to the prevalence among infants tested for CMV following clinical suspicion of a congenital infection. Methods: In November 2013, the “Programme québécois de dépistage de la surdité chez les nouveau-nés” (PQDNS) a provincially mandated hearing screening program was implemented at Centre Hospitalier Universitaire Sainte-Justine, a tertiary maternal-child health center in Montreal, Quebec, along with targeted CMV screening for all infants who failed their hearing test (excluding patients in the neonatal intensive care unit). Concurrently, beginning in April 2013, all infants of HIV exposed mothers were screened for cCMV infection within 48hrs of birth. Results: Out of 11 734 newborns screened for hearing through the PQDSN program between April 2014-March 2018, 536 failed their initial hearing screen, and 4 of these newborns tested positive for cCMV infection (0.75%). Out of a total of 130 HIV exposed newborns born during this period, 116 were screened for cCMV, and 3 (2.6%) confirmed positive. Overall, 455 newborns were identified by the attending pediatrician as having a risk factor for any congenital infection; of these, 22 (5.3%) tested positive for cCMV. Using these combined methods, a total of 0.24% of newborns enrolled in the PQDSN program tested positive for cCMV infection, Conclusions: The overall birth prevalence of cCMV was 0.75% among infants who failed their hearing screen, 2.6% among HIV exposed newborns, and 5.3% among infants with a clinical suspicion of a congenital infection. In the absence of universal screening, these results reinforce the importance of maintaining a high index of clinical suspicion for congenital infections.

  • To compare and contract the effectiveness of two different targeted screening methods for cCMV infection
  • To determine the effectiveness of symptom based screening
  • To understand the prevalence of cCMV infection among newborns in a tertiary care center in Quebec, Canada

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Fatima Kakkar (Primary Presenter), fatima.kakkar@umontreal.ca;
Fatima Kakkar is a Paediatric infectious diseases specialist and clinician researcher at the University of Montreal, Sainte-Justine Hospital Center, and chair of the Canadian Paediatric and Perinatal AIDS research group. Her interests have expanded recently from paediatric HIV to other congenital infections, and specifically cCMV infection.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Christian Renaud (Co-Author), christian.renaud@umontreal.ca;
Christian Renaud is a pediatric infectious diseases specialist and medical microbiologist, who specialises in paediatric virology.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Mina Smiljkovic (Co-Author), mina.m.smiljkovic@gmail.com;
Mina Smiljkovic is currently a paediatric infectious diseases fellow at the Hospital for Sick Children, working on the Sainte-Justine cCMV cohort as her research project through fellowship.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Isabelle Boucoiran (Co-Author), isabelle.boucoiran@umontreal.ca;
Isabelle Boucoiran is a maternofetal medicine and reproductive infectious disease specialist as well as a clinician scientist.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - Receives support from Canadian Institutes for Health Research.  




Silvie Valois (Co-Author), cmis@recherche-ste-justine.qc.ca;
Silvie Valois is a research nurse working with the CMIS cohort of perinatal infections.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Bruce Tapiero (Co-Author), bruce.tapiero@umontreal.ca;
Bruce Tapiero is current head of the division of infectious diseases, and integral in the creation of the new center for perinatal infectious diseases at Sainte-Justine Hospital center, in Montreal

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Valerie Lamarre (Co-Author), valerie.lamarre@umontreal.ca;
Valerie Lamarre is a pediatric infectious diseases specialist, focusing on perinatal infections in the province of Quebec.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.