P3.F116: Characterization of congenital CMV Screening: determining incidence and impact on clinical care

Background: The overall prevalence of congenitally acquired cytomegalovirus (cCMV) in the United States is 0.58%, making it the most common congenitally acquired infection and a major cause of sensorineural hearing loss in infants. While some infants with cCMV present with severe signs and symptoms, most are asymptomatic. cCMV can lead to progressive sensorineural hearing loss that may be present at birth or develop later in childhood. Early identification of infants with hearing loss can minimize deleterious effects on late neurodevelopment. In some cases, antiviral treatments can prevent additional deterioration in hearing and improve developmental outcomes, leading several groups to advocate for cCMV screening. Tampa General Hospital (TGH) initiated a targeted cCMV screening in 2023 using a salivary PCR test in high-risk populations in accordance with the Florida State Newborn Screening programs.

Our objective is to determine the incidence of cCMV in high-risk infants at TGH who were screened during their birth hospitalization. We hypothesize the incidence of cCMV in high-risk infants is higher than previously reported in the general population.

Methods: In collaboration with TGH Business Intelligence, we developed a daily report of newborns who met criteria for cCMV screening to ensure compliance with hospital and state guidelines. Data was collected from (02/2023 to 3/2024) and included indication for screening, screening results, and basic demographic data. De-identified data were transferred to a USF Redcap Database and analyzed.

Results: Indications for screening in our population included: failed newborn hearing screen (68.0%), prematurity or anticipated NICU stay of > 3 weeks (31.4%) and clinical suspicion for CMV infection (0.6%). Three of 806 infants screened positive (0.4%) and subsequently confirmed to have cCMV. Two infants were born at term: one was screened due to a failed hearing screen and the other was screened due to clinical suspicion. One preterm infant was identified due to clinical suspicion who also failed the newborn hearing screen.

Conclusion: Implementation of targeted screening for congenital CMV at TGH successfully identified infants that may benefit from long term follow-up and/or antiviral treatment. The incidence of cCMV in our high-risk population was similar to what was been previously reported in the literature for the general population. Consideration of expanded screening criteria is warranted.