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Comment & Response
May 3, 2021

Dried Blood Spot Testing for Detection of Congenital Cytomegalovirus—Reply

Author Affiliations
  • 1Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Medical School, Minneapolis
  • 2Minnesota Department of Health, Public Health Laboratory, Newborn Screening, St Paul
  • 3US Centers for Disease Control and Prevention, Atlanta, Georgia
JAMA Pediatr. 2021;175(8):866. doi:10.1001/jamapediatrics.2021.0758

In Reply Blázquez-Gamero et al have questioned 2 aspects of our report on cytomegalovirus (CMV) screening that we are happy to address. The correspondents suggest that one study limitation was our 92.9% sensitivity for saliva testing in contrast to the CHIMES study that they maintain showed 100% sensitivity for saliva testing in the report by Ross et al.1 However, the Ross et al study design did not assess saliva testing sensitivity. Ross et al1 compared the results of rapid culture and polymerase chain reaction (PCR) testing on saliva and urine specimens collected from 80 children with confirmed congenital CMV (cCMV) infection from their CHIMES screening study.2 Assay concordance was high (96%-100%) across all comparisons, but because the 80 children were initially selected based on having a CMV-positive saliva rapid culture or PCR result, high test concordance would be expected and does not assess saliva assay sensitivity. Our study performed unselected screening and compared dried blood spot (DBS) PCR with saliva PCR where we did observe infants with negative saliva and positive DBS results.3 We suggest our results reflect not only a different study methodology from the CHIMES study but also enhanced sensitivity of DBS for detection of cCMV.

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