{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:39:09Z","timestamp":1793054349281,"version":"4.5.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Congenital cytomegalovirus (cCMV) is the leading cause of neurodevelopmental and hearing impairment from <jats:italic>in-utero<\/jats:italic> infection. Late diagnosis results in limited treatment options and may compromise long-term outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective audit of infants with cCMV referred to a Tertiary Pediatric Infectious Diseases center from 2012\u20132021. Data collected included timing of diagnostics, treatment initiation and reasons for delays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>90 infants with confirmed cCMV were included, 46\/90 (51%) were symptomatic at birth. Most common reasons for diagnostics in asymptomatic infants were failed newborn hearing screening (17\/44, 39%) and antenatal risk-factors (14\/44, 32%). Median age at cCMV diagnosis was 3 (range 0\u201368) and 7 (0\u2013515) days, with median referral age 10 (1\u2013120) and 22 (2\u2013760) days for symptomatic and asymptomatic infants respectively. There was a significant risk of delay in diagnosis (&amp;gt;21 days) for asymptomatic infants [RR 2.93 (1.15\u20137.45); <jats:italic>p<\/jats:italic> = 0.02]. Of asymptomatic infants who received treatment, 13\/24 (54%) commenced it within 28 days of life, a significant delay in treatment compared to 30\/36 (83%) symptomatic infants [RR 2.75 (1.18\u20136.43); <jats:italic>p<\/jats:italic> = 0.02]. The commonest reason for delayed treatment initiation was delayed first diagnostic test for both symptomatic 4\/6 (67%) and asymptomatic infants 9\/11 (82%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Delays in diagnosis and treatment for cCMV are unacceptably frequent and significantly higher in asymptomatic infants. Our study highlights the need for increased awareness among healthcare professionals, reconsideration of age-targets for Newborn Hearing Screening, and research that addresses the barriers to implementation of universal screening, which would ultimately facilitate prompt diagnosis and management of all infants with cCMV.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.988039","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T09:42:18Z","timestamp":1663148538000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Delays in diagnosis and treatment initiation for congenital cytomegalovirus infection - Why we need universal 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