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1045 TRANSMISSION OF CYTOMEGALOVIRUS WITHIN A LARGE NEONATAL INTENSIVE CARE NURSERY

Acquired cytomegalovirus (CMV) infections are associated with significant morbidity and mortality for very low birthweight (LEW) infants, <1300gm, and infant-to-infant transmission has apparently occurred. Therefore, CMV acquisition by all infants hospitalized over 30 days was prospectively studied in a 60-bed neonatal intensive care nursery for 24 months. All newborn urines were cultured for CMV at birth and weekly until discharge. Sera from all LEW infants were assayed for IgG against CMV(EIA). All LEW infants lacking IgG against CMV (seronegative) received blood products from seronegative donors. Of 87 LEW infants born with IgG against CMV (seropositive), 7 acquired CMV while hospitalized. Of 71 LEW seronegative infants none acquired CMV (p<0.01 compared to seropositive infants). Infants with CMV viruria received no special isolation proceedures. No infant acquiring CMV received breast milk. EcoRI digestion of the DMAs of 13 CMV isolates from infants (acquired and congenital) during the last year showed no identical isolates. These results prove that transmission of CMV from infant to infant within a large neonatal intensive care unit occurs without significant frequency.