Sains Malaysiana 51(1)(2022): 239-247

http://doi.org/10.17576/jsm-2022-5101-19

The Prevalence of Cytomegalovirus (CMV) Infection among Infants and Correlation between CMV PCR with Clinical Outcomes in a Tertiary Teaching Hospital in Malaysia

(Prevalens Jangkitan Sitomegalovirus (CMV) dalam Kalangan Bayi dan Korelasi antara CMV PCR dengan Hasil Klinikal di Hospital Pengajaran Tertier di Malaysia)

NORJIHAN ABDUL HAMID^1,2, NABILAH ISMAIL^1,2, ALWI MUHD BESARI @ HASHIM^2,3, SUHARNI MOHAMAD⁴ & ZETI NORFIDIYATI SALMUNA^1,2*

¹Department of Medical Microbiology & Parasitology, School of Medical Sciences Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

²Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

³Department of Internal Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

⁴School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan Darul Naim, Malaysia

Received: 24 August 2020/Accepted: 19 April 2021

ABSTRACT

Congenital cytomegalovirus (cCMV) infection is the leading infectious cause of congenital hearing loss and neurodevelopmental disability. This study aimed to describe the prevalence and clinical manifestations of infants age 12 months and below with CMV infection in Hospital Universiti Sains Malaysia (Hospital USM) and to determine the correlation between CMV PCR with clinical outcomes. A total of 648 hospitalized infants with clinically suspected cases of cytomegalovirus infection admitted to Hospital USM from January 2018 to December 2018 were tested for anti-CMV IgM and IgG by electrochemiluminescence immunoassay method. The results suggestive of CMV infection were requested for the second serum sample at 2-4 weeks’ interval together with plasma samples for CMV DNA viral load quantification by real-time PCR and maternal sample for serological analysis. Correlation of CMV viral load with clinical outcomes was analyzed using the point- biserial correlation. The results showed that the prevalence of acute CMV infection was 6.48 % (42/648) and cCMV infection was 0.3% (n=2/648). The findings were as follows: acute CMV infection (n = 42), passive immunity (n = 113) and inconclusive (n =41).) CMV hepatitis (p-value= 0.018), rash (p-value= 0.043), presumed sepsis (p-value=0.044) and abnormal hearing (p-value 0.031) were significantly associated with CMV status. Significant moderate correlation between CMV viral load and abnormal hearing assessment was observed. As a conclusion, CMV hepatitis, presumed sepsis, rash, and abnormal hearing were associated with the infant's CMV status. A significant correlation was found between CMV viral load and abnormal hearing.

Keywords: Cytomegalovirus; infants; PCR; prevalence; serology

ABSTRAK

Jangkitan sitomegalovirus kongenital (cCMV) adalah antara penyebab utama kehilangan pendengaran kongenital dan kecacatan perkembangan saraf. Kajian ini bertujuan untuk mengetahui prevalens dan manifestasi klinikal bayi berumur 12 bulan dan ke bawah dengan jangkitan CMV di Hospital Universiti Sains Malaysia (Hospital USM) dan untuk menentukan korelasi antara CMV PCR dengan hasil klinikal. Seramai 648 bayi yang dirawat di hospital dengan kes yang disyaki secara klinikal terdapat jangkitan sitomegalovirus yang dimasukkan ke Hospital USM dari Januari 2018 hingga Disember 2018 diuji untuk anti-CMV IgM dan IgG dengan kaedah elektrokemiluminesen immunoesei. Keputusan yang menunjukkan jangkitan CMV diminta untuk menghantar sampel serum kedua pada selang 2-4 minggu bersama dengan sampel plasma untuk viral load CMV DNA kuantifikasi dengan PCR masa nyata dan sampel ibu untuk analisis serologi. Korelasi antara CMV viral load dengan hasil klinikal dianalisis menggunakan korelasi point-biserial. Keputusan menunjukkan prevalens jangkitan CMV akut adalah 6.48% (42/648) dan jangkitan cCMV adalah 0.3% (n = 2/648). Penemuannya adalah seperti berikut: jangkitan CMV akut (n = 42), imuniti pasif (n = 113) dan tidak meyakinkan (n = 41).) Hepatitis CMV (nilai p = 0,018), ruam (nilai p = 0,043), disyakki sepsis (nilai-p = 0,044) dan pendengaran yang tidak normal (nilai-p 0,031) dikaitkan secara signifikan dengan status jangkitan CMV. Wujud hubungan yang sederhana signifikan antara CMV viral load dan pendengaran yang tidak normal. Kesimpulannya, hepatitis CMV, sepsis, ruam dan pendengaran yang tidak normal dikaitkan dengan status jangkitan CMV bayi. Hubungan korelasi yang signifikan didapati antara viral load CMV dan pendengaran yang tidak normal.

Kata kunci: Bayi; PCR; prevalens; serologi; sitomegalovirus

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*Corresponding author; email: zetifidiyati@usm.my