Targeted screening for congenital cytomegalovirus infection in infants who fail universal newborn hearing screen

Introduction: Given the importance of early antiviral treatment in infants with sensorineural hearing loss secondary to congenital cytomegalovirus infection (cCMV), we submit a protocol for early diagnosis of cCMV according to the outcome of universal newborn hearing screening using automated auditory brainstem responses (AABR) (targeted CMV screening). Material and methods: Based on current knowledge provides by literature, we elaborate an action algorithm agreed between the coordinators of the Early Hearing Detection and Intervention program in Castilla y Leon (Spain). Results: If the first AABR test is a refer result for one or both ears, we request the identification of the viral genome by PCR in a urine sample within 15 days. The confirmation of uni or bilateral sensorineural hearing loss, allows the beginning of the antiviral treatment, before the first month of life. Discussion: Universal screening of cCMV enables monitoring of all infected infants, identifying cases of late-onset/progressive hearing loss sooner; but in the presence of an unknown cause- sensorineural hearing loss from the first two weeks of life, efforts must be made to rule out cCMV infection, although it is more complicated under these conditions. Conclusion: The inclusion of cCMV diagnosis into neonatal hearing screening program, will allow early detection of congenital infection in some infants, improving their quality of life.