Incidence of congenital and postnatal cytomegalovirus infection during the first year of life in Mexican preterm infants

• Published in: Journal of medical virology Vol. 94; no. 7; pp. 3349 - 3358
• Main Authors: Cadena‐Mota, Sandra, Muñoz‐Escalante, Juan C., Martínez‐Rodríguez, Luz E., Bernal‐Silva, Sofía, Tello‐Martínez, Nallely, Torre‐Rodríguez, Ileana, Hernández‐Sánchez, Pedro G., Castillo‐Martínez, Fernanda, Escalante‐Padrón, Francisco, Lima‐Rogel, Victoria, González‐Ortiz, Ana M., Noyola, Daniel E.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-07-2022
• Subjects: Breast Feeding; breast milk; Breastfeeding & lactation; Congenital infection; Cytomegalovirus; Cytomegalovirus - genetics; Cytomegalovirus Infections; Female; Gene sequencing; Health risks; herpesvirus; Humans; Incidence; Infant; Infant, Newborn; Infant, Premature; Infants; Infections; Milk, Human; Neonates; Newborn babies; Postnatal infection; Premature babies; Virology; Viruses; breast milk; postnatal infection; congenital infection; cytomegalovirus; herpesvirus
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.27705

Cytomegalovirus infection occurs commonly during infancy. Postnatal infection in term infants is usually asymptomatic; however, infection in preterm infants can be associated with clinical manifestations during the neonatal period. Nevertheless, few studies to assess the frequency of cytomegalovirus infection in preterm infants have been performed outside of high‐income countries. We analyzed the incidence of congenital and postnatal cytomegalovirus infection in a cohort of preterm infants. Cytomegalovirus infection was detected during the neonatal period in four of 178 infants; in three of them, the virus was detected during the first 3 weeks of life and, therefore, congenital infection was confirmed (1.7% incidence). Postnatal infection was detected in 44 (36.4%) of 121 infants who were assessed after discharge from the neonatal intensive care unit. Cytomegalovirus infection was significantly associated with the duration of breastfeeding. In addition, we characterized cytomegalovirus strains detected in infants together with sequences available at GenBank, based on sequences of the UL18 gene. Cytomegalovirus UL18‐sequences clustered in five distinct clades (A–E), and sequences obtained from infants in our study were distributed in four of the five clades; 44.4% of these sequences were included in clade E. Breastfeeding duration was shorter on average (5.6 months) in infants with sequences in clade E compared to infants with sequences in the other three clades (8.2 months; p = .07). In conclusion, we provide information regarding the high incidence of cytomegalovirus infection in preterm infants. Further studies are warranted to assess if cytomegalovirus strain characteristics are associated with the risk of infection acquisition during infancy.
Highlights
Confirmed congenital CMV infection was detected in 3 (1.7%) of 178 preterm infants.
Postnatal CMV infection occurred in 44 (36.4%) of 121 preterm infants followed‐up during the first year of life. Breastfeeding duration was associated with CMV infection during the first year of life.
CMV UL‐18 gene sequences identified in preterm infants were distributed in four of five UL‐18 clades.