Distinction between congenita! and postnatal CMV infection through Guthrie cards examination.

CMV isolation from urine, saliva or heparinized blood of infants 24 weeks old doesn't allow the distinction between congenitally and postnatally acquired infections. A method of CMV DNA extraction from newborn dried blood spots (DBS) on Guthrie cards followed by a PCR amplification that proved I 00%iensible and 98% specific was used to ascertain the nature of the CMV infection diagnosed it22617ants (26 days - 12 months old) by virus isolation in ce!! culture DBS collected in the first weeks of fife were obtained from the regional screening laboratory and subjected to heat extraction procedure in celi culture medium (MEM). CMV DNA was detected through a nested PCR amplifying a _100 bp region in the gp58 gene followed by agarose gel electrophoresis. An "in utero" acquisition of the infection wasascertained in 9 infants and was excluded in 31.. An uncorrect timing of DBS collection precluded the diagnosis in g infants. None of the 6 isolation negative cases proved positive on DBS. One out of 7 additional cases without virological assessment of CMV infection proved congenitally infected.The study method was able to exclude an infection due to transfusion in 3 of 12 infants transfused in the first weeks of life.The ascertainment of the type of CMV infection by the study method allows implementing a clinica! monitoring program .to detect late sequelae and ascertaining the role of transfusion in neonata! infection and the role of CMV in neurologic damage occurring in early infancy.