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Licensed Unlicensed Requires Authentication Published by De Gruyter May 16, 2018

Detection of cytomegalovirus in saliva from infants undergoing sepsis evaluation in the neonatal intensive care unit: the VIRIoN-C study

Andrea Ronchi, Christopher P. Ouellette, Asuncion Mejías, Douglas Salamon, Amy Leber, Lorenza Pugni, Fabio Mosca and Pablo J. Sánchez



To determine the frequency of detection of cytomegalovirus (CMV) among infants evaluated for late-onset sepsis in the neonatal intensive care unit (NICU).


This study was a prospective cohort study.


During the 13-month study, 84 infants underwent 116 sepsis evaluations, and CMV DNA was detected in saliva in three (4%) infants (median: gestational age 28 weeks, birth weight 950 g), representing 5% (n=6) of all sepsis evaluations. One infant had CMV DNA detected in saliva in all four sepsis evaluations. Two infants had acquired CMV infection, while the timing of CMV acquisition could not be determined in one infant. Two of the three infants had concomitant Gram-negative bacteremia and urinary tract infections (UTIs), two developed severe bronchopulmonary dysplasia (BPD) and none died.


Detection of CMV DNA in saliva occurred in 4% of infants and 5% of sepsis evaluations. Persistence of CMV DNA shedding in saliva made attribution of clinical illness difficult to ascertain.

Corresponding author: Pablo J. Sánchez, MD, Department of Pediatrics, Divisions of Neonatal-Perinatal Medicine and Pediatric Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Pediatrics, Divisions of Neonatology and Pediatric Infectious Diseases, Nationwide Children’s Hospital – The Ohio State University College of Medicine, Columbus, OH, USA; Center for Perinatal Research, The Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA; and Nationwide Children’s Hospital – The Ohio State University, 700 Children’s Drive, RB3, WB5245, Columbus, OH 43205-2664, USA, Tel.: +614-355-6638
aAndrea Ronchi and Christopher P. Ouellette: These authors contributed equally to this work.


The authors thank the following employees of Parkland Memorial Hospital: John Gard, Pharm. D., Melody Bush, RPh, Sara Mureeba, Pharm. D., and Sheeba Tharayil, Pharm. D. of the NICU pharmacy for assistance with identification of study patients, Lea Maria Pereira Mendes of Language Services for support in patient recruitment and consenting and the NICU nurses for assistance with sample collection.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Article note

The study was presented in part at the Pediatric Academic Societies’ Annual Meeting, Baltimore, MD, April 30–May 3, 2016.

Received: 2018-01-14
Accepted: 2018-04-11
Published Online: 2018-05-16
Published in Print: 2018-12-19

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