Postnatally acquired CMV meningitis diagnosed via BioFire FilmArray: A case report

2020 ◽  
pp. 1-6
Author(s):  
A. Stark ◽  
J. Peterson ◽  
K. Weimer ◽  
C. Hornik
Keyword(s):  
Case Report ◽  
Birth Weight ◽  
Breast Milk ◽  
Premature Infants ◽  
Gold Standard ◽  
Very Low Birth Weight ◽  
Definitive Treatment ◽  
Cmv Infection ◽  
Term Infants ◽  
Low Birth Weight Infant

Postnatally acquired cytomegalovirus (CMV) is commonly acquired via breast milk, with premature infants more frequently developing symptoms of CMV infection in comparison to term infants. Meningitis is a rare clinical manifestation of CMV infection. The diagnosis of meningitis is difficult to make in infants, particularly those who are preterm. Consequentially, broad-spectrum empiric antimicrobial coverage is often administered for several days while waiting for current gold standard CSF testing to result. The BioFire FilmArray (BFA) simultaneously tests for 14 different pathogens, including CMV, allowing for quicker diagnosis and shorter time to definitive treatment. Here, we report a very low birth weight infant with postnatally acquired CMV meningitis, the first to our knowledge to be diagnosed using the BioFire FilmArray.

scholarly journals Observational study of cytomegalovirus from breast milk and necrotising enterocolitis

2019 ◽  
Vol 105 (3) ◽  
pp. 259-265 ◽  
Author(s):  
Ravi Mangal Patel ◽  
Neeta Shenvi ◽  
Andrea Knezevic ◽  
Michael Hinkes ◽  
George W Bugg ◽  
...  
Keyword(s):  
Viral Load ◽  
Birth Weight ◽  
Breast Milk ◽  
Very Low Birth Weight ◽  
Congenital Infection ◽  
Necrotising Enterocolitis ◽  
Cmv Infection ◽  
Low Birth Weight Infants ◽  
Cox Models ◽  
The Relationship

ObjectiveTo evaluate the relationship between cytomegalovirus (CMV) exposure from breast milk and risk of necrotising enterocolitis (NEC).DesignSecondary analysis of a multicentre, observational cohort study. Maternal breast milk and infant serum or urine were serially evaluated by nucleic acid testing at scheduled intervals for CMV. Infants with evidence of congenital infection were excluded. Competing-risks Cox models, with adjustment for confounders, were used to evaluate the relationship between breast milk CMV exposure or postnatal CMV infection and NEC.SettingThree neonatal intensive care units in Atlanta, Georgia.PatientsInfants with a birth weight≤1500 grams.ExposuresMaximal CMV viral load in breast milk in the first 14 days after birth or postnatal CMV infection. Two different approaches were used to assess the timing of onset of CMV infection (midpoint or early).Main outcome measuresNEC, defined as Bell stage II or greater.ResultsAmong 596 enrolled infants, 457 (77%) were born to CMV seropositive mothers and 33 developed postnatal CMV infection (cumulative incidence 7.3%, 95% CI 5.0% to 10.1%). The incidence of NEC was 18% (6/33) among infants with CMV infection, compared with 7% (37/563) among infants without infection (adjusted cause-specific HR (CSHR): 2.81; 95% CI 0.73 to 10.9 (midpoint); 6.02; 95% CI 1.28 to 28.4 (early)). Exposure to higher breast milk CMV viral load was associated with a higher risk of NEC (adjusted CSHR per twofold increase 1.28; 95% CI 1.06 to 1.54).ConclusionsCMV exposure from breast milk may be associated with the development of NEC in very low birth weight infants.

Shoulder dislocation in a very-low-birth-weight infant: case report and review of the literature

2009 ◽  
Vol 44 (12) ◽  
pp. e19-e20 ◽  
Author(s):  
Ronni Wessels ◽  
Christien Sleeboom ◽  
Johanna I.P. de Vries ◽  
Ruurd M. van Elburg
Keyword(s):  
Case Report ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Shoulder Dislocation ◽  
Very Low Birth Weight ◽  
Review Of The Literature ◽  
Low Birth Weight Infant ◽  
Infant Case

scholarly journals Transmission of cytomegalovirus via breast milk in low birth weight and premature infants: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaolin Hu ◽  
Wei Hu ◽  
Xuan Sun ◽  
Ling Chen ◽  
Xiaoping Luo
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Infection Rate ◽  
Premature Infants ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Feeding Practice ◽  
Mixed Feeding ◽  
Cmv Infection

Abstract Background This study aimed to investigate the transmission of cytomegalovirus (CMV) via breast milk in low birth weight (LBW) and premature infants and its effects. Methods PubMed, Medline, Cochrane Library, and Embase were searched for studies (without language and time restriction) published before March 27, 2020, that examined the effect of CMV transmitted by breast milk on LBW and premature infants. The rates of breast milk-acquired CMV infection, CMV-related symptoms, and CMV-related sepsis-like syndrome (CMV-SLS) in LBW and premature infants were pooled from each study. Results Eighteen studies with 1920 LBW and premature infants were included. The pooled CMV infection rate from breast milk for infants fed untreated breast milk was significantly higher than those fed frozen breast milk [19.3, 95% confidence interval (CI) = 11.8–29.9% vs. 13.5, 95% CI = 8.0–22.0%, P < 0.01). Similarly, the pooled CMV infection rate for infants fed untreated breast milk was significantly higher than those with mixed feeding (P < 0.0001). The mixed feeding group had a significantly lower rate of CMV-related symptoms than the other groups (2.4%, P < 0.01). Conclusions These findings suggested a higher CMV infection rate in LBW or premature infants fed untreated breast milk than other feeding groups. Studies on the long-term outcomes of CMV infection transmitted from breast milk are needed to address the optimal feeding practice.

Donor Breast Milk for the Preterm Infant: Your Questions Answered!

2019 ◽  
Vol 38 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Stephanie Merlino-Barr ◽  
Sharon Groh-Wargo
Keyword(s):  
Birth Weight ◽  
Breast Milk ◽  
Gold Standard ◽  
Very Low Birth Weight ◽  
Infant Nutrition ◽  
Nutritional Management ◽  
Maternal Milk ◽  
Vlbw Infants ◽  
Expressed Breast Milk

Expressed breast milk (EBM) is the gold standard of infant nutrition, but is not always available for use for preterm infants in the NICU setting. Donor breast milk (DBM) is often a preferred alternative for preterm and very low birth weight (VLBW) infants when maternal milk is not available. This article discusses the composition of DBM, reviews its advantages compared to formula, discusses challenges related to its long-term use, and identifies strategies to utilize DBM in the context of total nutritional management of preterm and VLBW infants. We will use a framework of WHO, WHAT, WHERE, WHEN, and WHY to answer the questions: who gets DBM, why use DBM, where does DBM come from, what is in DBM, and when may DBM use be challenged.

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