The Use of Saliva Samples to Test for Congenital Cytomegalovirus Infection in Newborns: Examination of False-Positive Samples Associated with Donor Milk Use

Whitney Wunderlich, Abbey C. Sidebottom, Anna K. Schulte, Jessica Taghon, Sheila Dollard, Nelmary Hernandez-Alvarado

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

A universal screening research study was conducted in six hospitals to identify the clinical sensitivity of polymerase chain reaction (PCR) testing on newborn dried blood spots (DBSs) versus saliva specimens for the diagnosis of congenital cytomegalovirus (cCMV). CMV DNA positive results from DBSs or saliva were confirmed with urine testing. Findings of several false-positive (FP) saliva PCR results prompted an examination of a possible association with donor milk. Documentation of the frequency of positive saliva results, including both true-positive (TP) and FP status from clinical confirmation, occurred. The frequency of donor milk use was compared for TP and FP cases. Of 22,079 participants tested between 2016 and 2022, 96 had positive saliva results, 15 were determined to be FP, 79 TP, and 2 were excluded for incomplete clinical evaluation. Newborn donor milk use was identified for 18 (19.14%) of all the positive saliva screens. Among the 15 FPs, 11 (73.33%) consumed donor milk compared to 7 of the 79 TPs (8.8%) (OR 28.29, 95% CI 7.10–112.73, p < 0.001). While milk bank Holder pasteurization inactivates CMV infectivity, CMV DNA may still be detectable. Due to this possible association, screening programs that undertake testing saliva for CMV DNA may benefit from documenting donor milk use as a potential increased risk for FP results.

Original languageEnglish (US)
Article number46
JournalInternational Journal of Neonatal Screening
Volume9
Issue number3
DOIs
StatePublished - Sep 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • cCMV
  • cytomegalovirus
  • donor milk
  • newborn screening
  • saliva

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