2024 Early Hearing Detection & Intervention Conference
March 17-19, 2024 • Denver, CO
| Ensuring Timely Congenital Cytomegalovirus Testing and Follow-up for Babies Who Do Not Pass Newborn Hearing Screening at Mayo Clinic: Insights One Year Later
Ensuring Timely Congenital Cytomegalovirus Testing and Follow-up for Babies Who Do Not Pass Newborn Hearing Screening at Mayo Clinic: Insights One Year Later
Twenty-six percent of babies diagnosed with unexplained sensorineural hearing loss show evidence of congenital cytomegalovirus (cCMV); twenty-five percent of hearing loss in children by age four is likely attributed to cCMV. These numbers make cCMV the leading non-genetic cause of childhood hearing loss in the United States; however, there are not widespread established clinical practices for cCMV testing on babies who refer their initial newborn hearing screening (NHS). To help address this critical need, Mayo Clinic implemented clinical practice changes to identify and monitor babies who have cCMV. Specifically, if a child refers on the NHS he/she is to be tested for cCMV prior to dismissal from the hospital, or no later than 21 days of age, in addition to undergoing outpatient audiologic rescreening within 1 to 2 weeks of discharge. At the 2018 EHDI Annual Meeting, Mayo Clinic professionals from Audiology, Infectious Disease, Pediatrics, and Medical Genetics presented a team-based quality improvement project regarding these clinical practice changes for timely cCMV testing and follow-up for babies who do not pass initial NHS. This year we present follow-up data, current clinical practice workflows, and the discussion of how approximately 90% of infants who referred on NHS have been tested for cCMV since implementation of the new clinical practice standards. Recommendations and limitations for adoption of new clinical practices will be discussed. Finally, case illustrations examining audiological monitoring protocols for patients following identification of a cCMV diagnosis will be provided.
- Promote knowledge and awareness of successful strategies for identifying and monitoring infants with congenital cytomegalovirus for hearing loss.
- Discuss the importance of enhancing current protocols and creating new protocols for identifying and monitoring infants with congenital cytomegalovirus for hearing loss.
- Identify and address gaps related to audiologic services for patients with congenital cytomegalovirus (cCMV).
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Presenters/Authors
Kelsey Dumanch
(Point of Contact,Primary Presenter), Mayo Clinic Rochester, dumanch.kelsey@mayo.edu;
Kelsey Dumanch, Au.D., CCC-A is a pediatric audiologist at Mayo Clinic in Rochester, MN. She received her Au.D. from the University of Iowa in 2018 where she completed research on hearing aids and on OAEs, in addition to EHDI research with the Iowa Department of Public Health. She completed her externship at Mayo Clinic Rochester where her research was focused on pediatric ototoxicity monitoring, which remains a prominent research and clinical interest. Additional clinical interests include pediatrics (particularly improving EHDI programs, access, and outcomes), evoked potentials, and cochlear implants (particularly expanded candidacy criteria).
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Lee Belf
(Co-Presenter), Mayo Clinic Rochester, belf.lee@mayo.edu;
Lee received her B.A. and M.A. degrees at Western Michigan University. She received her Au.D. from University of Florida. Lee has been an audiologist at Mayo Clinic Rochester, MN since 1990 with her primary interest in Pediatric Audiology.
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Joscelyn Martin
(Co-Presenter), Mayo Clinic Rochester, martin.joscelyn@mayo.edu;
Joscelyn R.K. Martin, Au.D. is a pediatric audiologist at the Mayo Clinic in Rochester, Minnesota. She holds Pediatric Audiology Specialty Certification (PASC) from the American Board of Audiology. Dr. Martin has been coordinator of the Mayo Clinic Early Hearing Detection and Intervention (EHDI) program since its inception in 1999. In addition to early intervention for children with hearing loss, she is passionate about child and family centered counseling and the positive impact it has on the diagnostic and re/habilitative process for the families with whom she works.
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Lisa Schimmenti
(Author), Mayo Clinic Rochester, schimmenti.lisa@mayo.edu;
Dr. Schimmenti is a Senior Associate Consultant at Mayo Clinic in the departments of Otorhinolaryngology, Clinical Genomics and Biochemistry and Molecular Biology. She is the AAP Chapter Champion for Minnesota and the regional champion for Region VI. She has served on the Minnesota Department of Health Newborn Hearing Screening Committee for over a decade. Her basic science laboratory studies hearing and vision in zebrafish.
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Charles Huskins
(Author), Mayo Clinic Rochester, huskins.charles@mayo.edu;
Dr. Huskins' research is focused on improving health care by studying interventions to prevent health-care-associated infections and to improve use of antimicrobial agents, which can lead to infections caused by antimicrobial-resistant bacteria.
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Karthik Balakrishnan
(Author), Mayo Clinic Rochester, Balakrishnan.Karthik@mayo.edu;
Karthik Balakrishnan is a pediatric otolaryngologist at the Mayo Clinic Children’s Center in Rochester, MN. He joined the Mayo Clinic after finishing fellowship training at Cincinnati Children’s Hospital and serves as Chair of the ENT Quality Assurance Committee. His clinical interests span the full breadth of pediatric otolaryngology; research interests include surgical outcomes, quality improvement, costs of care, and the role of cognitive bias in medical decision-making.
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Gayla L. Poling
(Co-Presenter,Author), Mayo Clinic, Rochester, MN, poling.gayla@mayo.edu;
Gayla L. Poling, Ph.D. is the Director of Diagnostic Audiology Research at Mayo Clinic, Rochester, MN. She is an Assistant Professor of Audiology, Mayo Clinic College of Medicine. She studied Audiology and Hearing Sciences at The Ohio State University and completed postdoctoral fellowships at the Medical University of South Carolina and Northwestern University. Her primary interest is auditory diagnostics with her research focused on early detection and prevention of hearing loss across the life course.
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