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- Title
Sequence analyses of variable cytomegalovirus genes for distinction between breast milk- and transfusion-transmitted infections in very-low-birth-weight infants.
- Authors
Furui, Yasumi; Yamagishi, Naoji; Morioka, Ichiro; Taira, Rikizo; Nishida, Kosuke; Ohyama, Shohei; Matsumoto, Hisayuki; Nakamachi, Yuji; Hasegawa, Takashi; Matsubayashi, Keiji; Nagai, Tadashi; Satake, Masahiro
- Abstract
<bold>Background: </bold>Cytomegalovirus (CMV) transmission to very-low-birth-weight infants (VLBWIs) sometimes induces serious clinical symptoms. Although breast milk is considered a major source of transmission, transfusion-transmitted CMV (TT-CMV) infection is often suspected when CMV disease develops after transfusion. Thus, it is clinically important to distinguish between transfusion-transmitted and breast milk-transmitted CMV infections.<bold>Study Design and Methods: </bold>Study A: The incidence of acquired CMV transmission was prospectively investigated in 65 VLBWIs. Study B: To determine the transmission routes in 18 TT-CMV-suspected VLBWIs who had been reported in our hemovigilance system, we performed polymerase chain reaction for CMV DNA in fed breast milk and/or repository blood samples related to transfused leukoreduced blood products. Furthermore, we evaluated the identity of CMV strains in patients' urine/blood samples and fed breast milk by sequence analyses of variable CMV genes UL139 and UL146.<bold>Results: </bold>Study A: Acquired CMV infection was found in 4 of 65 VLBWIs (6.2%). Study B: CMV DNA was detected in fed breast milk for 12 of 14 TT-CMV-suspected cases, for which breast milk was available. Furthermore, CMV DNA sequence-matching rates between fed breast milk and patients' urine/blood for both UL139 and UL146 genes were 100% or nearly 100% in 11 patients. In contrast, repository blood samples for 11 of 14 patients were CMV DNA negative.<bold>Conclusion: </bold>CMV is principally transmitted through breast milk in VLBWIs. The risk of TT-CMV seems to be extremely low when using leukoreduced blood products. Sequence analyses of the variable CMV genes are useful for evaluating CMV transmission routes.
- Subjects
CYTOMEGALOVIRUS diseases; BREAST milk; BLOOD transfusion reaction; LOW birth weight; POLYMERASE chain reaction; SEQUENCE analysis; PROTEIN metabolism; DNA metabolism; COMPARATIVE studies; CYTOKINES; CYTOMEGALOVIRUSES; DNA; GENES; GENETICS; RESEARCH methodology; MEDICAL cooperation; PROTEINS; RESEARCH; RESEARCH funding; EVALUATION research; VERTICAL transmission (Communicable diseases); NEONATAL anemia; INFECTIOUS disease transmission
- Publication
Transfusion, 2018, Vol 58, Issue 12, p2894
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.14920