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July 28, 2010

Screening Newborns for Congenital Cytomegalovirus Infection—Reply

JAMA. 2010;304(4):407-408. doi:10.1001/jama.2010.1025

In Reply: Dr de Vries and colleagues and Drs Dollard and Schleiss believe that it was premature to conclude that DBS PCR assays are not suitable for newborn CMV screening. We agree that currently available DNA extraction methods and PCR protocols result in considerable variation in DBS PCR assay performance. To address these issues, we compared 2 different extraction methods and PCR protocols for detecting CMV DNA in DBS. Although changing the extraction method and the PCR protocol did not enhance the DBS PCR performance, we cannot discount that these methods could have missed infants with very low viral loads. However, a recent study found that 6 of 24 (25%) infants with symptomatic congenital CMV infection with significant neurologic involvement were whole blood PCR-negative, suggesting that not all symptomatic congenitally infected neonates have detectable viremia.1

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