(A918) Early Detection of Congenital Cytomegalovirus – Duke’s New Universal Screening Protocol

Introduction: Congenital cytomegalovirus (cCMV) is the most common congenital infection. It is a leading cause of neurodevelopmental delays and the leading non-genetic cause of sensorineural hearing loss. Infants are often asymptomatic at birth but develop delays within six years of life. Antiviral therapy and timely interventions have improved outcomes, making early detection crucial. This study describes the design and implementation of universal cCMV screening at a tertiary neonatal intensive care unit and introduces initial findings.

Methods: Implementation strategies for the program included emails, daily reminders, and addition of the lab test to order sets. We used chart review to analyze patient data and if all infants admitted were tested in the first 21 days of life.

Results: 702 infants have been tested, 681 (97.0%) within the first 21 days of life. Our cohort is 45.8% Caucasian, 39.5% Black, and 14.5% Hispanic/Latino. 57.9% of patients are insured through Medicaid. For CMV results, 13 infants tested positive with 7 tested in the first 21 days of life (diagnosed with cCMV). Out of those 7, 4 were symptomatic. 5 cCMV positive infants passed their initial newborn hearing screen. All have seen audiology, ophthalmology, and pediatric infectious disease.

Conclusions: There is a growing interest in implementing universal screening to identify infants with cCMV to improve outcomes. Currently, no standardized screening program exists in the Southeastern US. Duke’s implementation of this program may help provide a framework for the region and contribute to ongoing cCMV advocacy nationwide.