Implementation of pooled saliva tests for universal screening of cCMV infection

Lior Merav, Noa Ofek Shlomai, Esther Oiknine-Djian, Orit Caplan, Ayala Livneh, Tal Sido, Amir Peri, Aviad Shtoyer, Eden Amir, Kerem Ben Meir, Yutti Daitch, Mila Rivkin, Esther Kripper, Irit Fogel, Hadar Horowitz, Sraya Greenberger, Mevaseret Cohen, Miriam Geal-Dor, Oren Gordon, Diana AverbuchZivanit Ergaz-Shaltiel, Smadar Eventov Friedman, Dana G. Wolf*, Moran Yassour*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Congenital cytomegalovirus (cCMV) is the most common intrauterine infection, leading to neurodevelopmental disabilities. Universal newborn infant screening of cCMV has been increasingly advocated. In the absence of a high-throughput screening test, which can identify all infected newborn infants, the development of an accurate and efficient testing strategy has remained an ongoing challenge. Here we assessed the implementation of pooled saliva polymerase chain reaction (PCR) tests for universal screening of cCMV, in two hospitals of Jerusalem from April 2022 through April 2023. During the 13-month study period, 15,805 infants (93.6% of all live newborn infants) were screened for cCMV using the pooled approach that has since become our routine screening method. The empirical efficiency of the pooling was six (number of tested newborn infants per test), thereby sparing 83% of the saliva tests. Only a minor 3.05 PCR cycle loss of sensitivity was observed for the pooled testing, in accordance with the theoretical prediction for an eight-sample pool. cCMV was identified in 54 newborn infants, with a birth prevalence of 3.4 per 1,000; 55.6% of infants identified with cCMV were asymptomatic at birth and would not have been otherwise targeted for screening. The study demonstrates the wide feasibility and benefits of pooled saliva testing as an efficient, cost-sparing and sensitive approach for universal screening of cCMV.

Original languageAmerican English
Pages (from-to)1111-1117
Number of pages7
JournalNature Medicine
Issue number4
StatePublished - Apr 2024

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© The Author(s) 2024.


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