CYTOMEGALOVIRUS-INFECTION OF PRETERM INFA NTS BY BREAST-MILK

Background: After elimination of CMV transmission by blood products we have still observed preterm infants with postnatally acquired CMV inf ections. 16 preterm infants with CMV infection by breast milk were ide ntified. Methods: CMV-DNA PCR and viral cultures. Criteria of transmis sion: CMV in breast milk; viruria in preterm infants; exclusions of co ngenital infection, of donor's breast milk and of CMV seropositive blo od transfusions. Results: 8 infants (50%) had marked symptoms of an ac ute 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). Conclusio n: There is a high incidence of symptomatic CMV infections in preterm infants due to breast milk transmission. An early postnatal CMV infect ion seems to be associated with a symptomatic clinical course.