---
title: "Hybrid Congenital CMV Screening in a Large Hospital System: Implementation and Outcomes"
id: "pubmed-42764176"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42764176"
content_type: "clinical_feed_article"
specialty: "Pediatrics"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42764176/"
doi: "10.1542/peds.2026-076776"
published_at: "2026-09-21T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Hybrid Congenital CMV Screening in a Large Hospital System: Implementation and Outcomes
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42764176
- **Specialty:** [Pediatrics](https://medichelpline.com/clinical-feed/pediatrics.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42764176/)
- **DOI:** [10.1542/peds.2026-076776](https://doi.org/10.1542%2Fpeds.2026-076776)
- **Published At:** 2026-09-21T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The Cleveland Clinic implemented a multidisciplinary **congenital cytomegalovirus (cCMV)** screening and follow-up program across its Ohio enterprise using a **hybrid screening** approach: universal screening in NICUs and targeted screening in newborn nurseries. - From 2022–2025, among 50,438 live births, 7,491 infants (14.9%) were screened; annual testing rose from ~150 to >2,000 infants. - Thirty-four infants (0.45% of those screened) were confirmed with **cCMV**, representing an approximately 2.5-fold increase in case detection after program initiation. - Detection rates differed by setting: targeted newborn nursery screening identified cCMV at a higher rate (0.74%) than universal NICU screening (0.33%); this difference was statistically significant (P = .01). - The most frequent clinical findings among confirmed cases were abnormal neuroimaging (32.3%) and small for gestational age (26.5%). - Implementation succeeded in rapid workflow integration through multidisciplinary collaboration among clinical and laboratory specialties. - Follow-up care, especially **audiology** monitoring, was constrained by logistical, socioeconomic, and educational barriers experienced by families, limiting access to recommended post-diagnostic services. - The report concludes that hybrid **cCMV screening** is feasible at scale and increases detection, but highlights the need to improve access to audiology and other follow-up to maximize clinical benefit. - Details about specific laboratory methods, exact screening tests used, and granular follow-up outcomes were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Implementing Congenital CMV Screening in a Large Hospital System [Julia Tanzo](https://pubmed.ncbi.nlm.nih.gov/?term=Tanzo+J&cauthor_id=42764176)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-1 "Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio."), [Lisa McBride](https://pubmed.ncbi.nlm.nih.gov/?term=McBride+L&cauthor_id=42764176)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-2 "Section for Pediatric Infectious Disease, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Patrick Burke](https://pubmed.ncbi.nlm.nih.gov/?term=Burke+P&cauthor_id=42764176)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-3 "Department of Infection Prevention, Cleveland Clinic, Cleveland, Ohio."), [Carmen Jamis](https://pubmed.ncbi.nlm.nih.gov/?term=Jamis+C&cauthor_id=42764176)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-4 "Department of Audiology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio."), [Anirudha Das](https://pubmed.ncbi.nlm.nih.gov/?term=Das+A&cauthor_id=42764176)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-5 "Division of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Hany Aly](https://pubmed.ncbi.nlm.nih.gov/?term=Aly+H&cauthor_id=42764176)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-5 "Division of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Samantha Anne](https://pubmed.ncbi.nlm.nih.gov/?term=Anne+S&cauthor_id=42764176)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-6 "Department of Otolaryngology, Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio."), [Colleen Schelzig](https://pubmed.ncbi.nlm.nih.gov/?term=Schelzig+C&cauthor_id=42764176)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-7 "Division of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Stephanie Jennings](https://pubmed.ncbi.nlm.nih.gov/?term=Jennings+S&cauthor_id=42764176)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-7 "Division of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Daniel D Rhoads](https://pubmed.ncbi.nlm.nih.gov/?term=Rhoads+DD&cauthor_id=42764176)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-8 "Pathology and Laboratory Medicine Department, Cleveland Clinic, Cleveland, Ohio.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-9 "Microbial Sciences in Health Department, Cleveland Clinic, Cleveland, Ohio."), [Hannah Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+H&cauthor_id=42764176)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-8 "Pathology and Laboratory Medicine Department, Cleveland Clinic, Cleveland, Ohio."), [Frank Esper](https://pubmed.ncbi.nlm.nih.gov/?term=Esper+F&cauthor_id=42764176)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-1 "Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#full-view-affiliation-2 "Section for Pediatric Infectious Disease, Cleveland Clinic Children's Hospital, Cleveland, Ohio.") Affiliations Expand ### Affiliations * 1 Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio. * 2 Section for Pediatric Infectious Disease, Cleveland Clinic Children's Hospital, Cleveland, Ohio. * 3 Department of Infection Prevention, Cleveland Clinic, Cleveland, Ohio. * 4 Department of Audiology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio. * 5 Division of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio. * 6 Department of Otolaryngology, Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio. * 7 Division of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio. * 8 Pathology and Laboratory Medicine Department, Cleveland Clinic, Cleveland, Ohio. * 9 Microbial Sciences in Health Department, Cleveland Clinic, Cleveland, Ohio. * PMID: **42764176** * DOI: [ 10.1542/peds.2026-076776 ](https://doi.org/10.1542/peds.2026-076776) Item in Clipboard # Implementing Congenital CMV Screening in a Large Hospital System Julia Tanzo et al. Pediatrics. 2026. Show details Display options Display options Format Abstract PubMed PMID Pediatrics Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Pediatrics%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Pediatrics%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42764176/) . 2026 Sep 21:e2026076776. doi: 10.1542/peds.2026-076776. Online ahead of print. ### Authors [Julia Tanzo](https://pubmed.ncbi.nlm.nih.gov/?term=Tanzo+J&cauthor_id=42764176)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-1 "Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio."), [Lisa McBride](https://pubmed.ncbi.nlm.nih.gov/?term=McBride+L&cauthor_id=42764176)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-2 "Section for Pediatric Infectious Disease, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Patrick Burke](https://pubmed.ncbi.nlm.nih.gov/?term=Burke+P&cauthor_id=42764176)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-3 "Department of Infection Prevention, Cleveland Clinic, Cleveland, Ohio."), [Carmen Jamis](https://pubmed.ncbi.nlm.nih.gov/?term=Jamis+C&cauthor_id=42764176)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-4 "Department of Audiology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio."), [Anirudha Das](https://pubmed.ncbi.nlm.nih.gov/?term=Das+A&cauthor_id=42764176)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-5 "Division of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Hany Aly](https://pubmed.ncbi.nlm.nih.gov/?term=Aly+H&cauthor_id=42764176)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-5 "Division of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Samantha Anne](https://pubmed.ncbi.nlm.nih.gov/?term=Anne+S&cauthor_id=42764176)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-6 "Department of Otolaryngology, Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio."), [Colleen Schelzig](https://pubmed.ncbi.nlm.nih.gov/?term=Schelzig+C&cauthor_id=42764176)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-7 "Division of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Stephanie Jennings](https://pubmed.ncbi.nlm.nih.gov/?term=Jennings+S&cauthor_id=42764176)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-7 "Division of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio."), [Daniel D Rhoads](https://pubmed.ncbi.nlm.nih.gov/?term=Rhoads+DD&cauthor_id=42764176)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-8 "Pathology and Laboratory Medicine Department, Cleveland Clinic, Cleveland, Ohio.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-9 "Microbial Sciences in Health Department, Cleveland Clinic, Cleveland, Ohio."), [Hannah Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+H&cauthor_id=42764176)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-8 "Pathology and Laboratory Medicine Department, Cleveland Clinic, Cleveland, Ohio."), [Frank Esper](https://pubmed.ncbi.nlm.nih.gov/?term=Esper+F&cauthor_id=42764176)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-1 "Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42764176/#short-view-affiliation-2 "Section for Pediatric Infectious Disease, Cleveland Clinic Children's Hospital, Cleveland, Ohio.") ### Affiliations * 1 Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio. * 2 Section for Pediatric Infectious Disease, Cleveland Clinic Children's Hospital, Cleveland, Ohio. * 3 Department of Infection Prevention, Cleveland Clinic, Cleveland, Ohio. * 4 Department of Audiology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio. * 5 Division of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, Ohio. * 6 Department of Otolaryngology, Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio. * 7 Division of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio. * 8 Pathology and Laboratory Medicine Department, Cleveland Clinic, Cleveland, Ohio. * 9 Microbial Sciences in Health Department, Cleveland Clinic, Cleveland, Ohio. * PMID: **42764176** * DOI: [ 10.1542/peds.2026-076776 ](https://doi.org/10.1542/peds.2026-076776) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background and objectives:** Congenital cytomegalovirus (cCMV) is the most common congenital infection and the leading nongenetic cause of sensorineural hearing loss. Despite expanding legislative screening requirements across the United States, there is no consensus guidance on the screening approach, resulting in wide variation in implementation. Our objective was to assess the outcomes and provide operational insights of initiating cCMV screening within a large hospital system. **Methods:** A multidisciplinary team representing key clinical and laboratory specialties developed a comprehensive cCMV screening and follow-up program. Infants born within the Cleveland Clinic Ohio enterprise were screened through a hybrid screening protocol (universal screening in neonatal intensive care units and targeted screening in newborn nurseries). Detection rates and implementation insights were compiled. Clinical outcomes were assessed through retrospective medical record review. **Results:** Among 50 438 live births, 7491 infants (14.9%) underwent cCMV screening from 2022 to 2025, increasing annual testing from approximately 150 to over 2000 infants. Thirty-four infants (0.45%) were confirmed to have cCMV, increasing case detection approximately 2.5-fold, with higher detection rates in targeted vs universal groups (0.74% vs 0.33%; P = .01). The most common clinical findings were abnormal neuroimaging (32.3%) and small for gestational age (26.5%). Although screening protocols were rapidly integrated into workflows, audiology follow-up was limited by logistical, socioeconomic, and educational barriers of families. **Conclusions:** Hybrid cCMV screening is feasible across a large health care system and increases detection. Multidisciplinary collaboration is essential to successful implementation. Improved access to audiology and other follow-up care is needed to maximize clinical impact. Copyright © 2026 by the American Academy of Pediatrics. 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