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.

先天性巨细胞病毒（cCMV）是最常见的宫内感染，可导致神经发育障碍。越来越多的人提倡对新生儿进行cCMV 筛查。由于缺乏能够识别所有受感染新生儿的高通量筛查测试，制定准确有效的测试策略仍然是一个持续的挑战。在这里，我们评估了 2022 年 4 月至 2023 年 4 月在耶路撒冷两家医院进行的用于 cCMV 普遍筛查的汇总唾液聚合酶链反应 (PCR) 检测的实施情况。在 13 个月的研究期间，15,805 名婴儿（占所有活新生儿的 93.6%）使用汇总方法对 cCMV 进行筛查，该方法后来成为我们的常规筛查方法。合并的经验效率为 6（每次测试测试的新生儿数量），从而节省了 83% 的唾液测试。根据八个样本池的理论预测，合并测试仅观察到 3.05 个 PCR 循环的敏感性损失。在 54 名新生儿中发现了 cCMV，出生患病率为每 1,000 人 3.4 例；55.6% 的 cCMV 婴儿在出生时没有症状，因此不会成为筛查的目标。该研究证明了混合唾液检测作为一种高效、节省成本且敏感的 cCMV 普遍筛查方法的广泛可行性和益处。