Cytomegalovirus infection of preterm infants by breast milk

Background: After elimination of CMV transmission by blood products we have still observed preterm infants with postnatally acquired CMV infections. 16 preterm infants with CMV infection by breast milk were identified. Methods: CMV-DNA PCR and viral cultures. Criteria of transmission: CMV in breast milk; viruria in preterm infants; exclusions of congenital infection, of donor's breast milk and of CMV seropositive blood transfusions. Results: 8 infants (50%) had marked symptoms of an acute CMV infection: sepsis-like symptoms with apnoea and bradycardia (4), cholestasis/hepatitis (4/2), thrombocytopenia (6), neutropenia (5). Infection in the lat ter group occurred at an median postnatal age of 46 vs. 62 days in asymptomatic infected infants (p < 0.01). Conclusion: There is a high incidence of symptomatic CMV infections in preterm infants due to breast milk transmission. An early postnatal CMV infection seems to be associated with a symptomatic clinical course.