Cytomegalovirus infection of extremely low-birth weight infants via breastmilk

In addition to seroprevalence and transmission rate, the clinical symptoms of postnatal cytomegalovirus (CMV) infection in infants with a very low bir th weight (VLBW; <1500 g; <32 weeks gestational age at birth) were assessed in a 3-year prospective study. CMV monitoring included serologic testing ( of the mother and child) and virus culture and PCR (of samples of both brea st milk and the infant's urine). Within 3 weeks of the initial virus detect ion in the infant, clinical and laboratory parameters were evaluated. Of 17 0 infants, no CMV transmission was found in the 80 infants of seronegative mothers and in the 3 infants of seropositive mothers who did not shed CMV D NA into breast milk. Transmission occurred in 33 of the 87 CMV-exposed infa nts, 16 of whom presented with such symptoms as hepatopathy, neutropenia, t hrombocytopenia, and sepsis-like deterioration. Low birth weight and early postnatal virus transmission were risk factors for symptomatic infection. V LBW infants of CMV-seropositive mothers are at high risk of acquiring a sym ptomatic CMV infection postnatally via breast milk.