Serum sICAM-1 levels in the diagnosis of neonatal infection

Edgar, J. D. M.; Gabriel, Vanessa; Craig, Albert B.; Wheeler, D; Thomas, Mark R.; Grant, J. W. Geary

doi:10.1203/00006450-199809000-00099

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“…The findings of a high sensitivity and a high negative predictive value of sICAM-1 in prematures is in accordance with Edgar et al [8]. This combination markedly increases the sensitivity and the negative predictive value compared to the sensitivity and nega-Brought to you by | University of California Authenticated Download Date | 6/8/15 7:59 PM tive predictive values for CRP and sICAM-1 singly.…”

Section: Discussionsupporting

confidence: 90%

“…Though limited knowledge is available of the functional roll of soluble ICAM-1 (sI-CAM-1) in infection [11] it seems probable that the concentration of the molecule rises very early in the inflammatory process. Five studies [2,6,8,9,14] supported usefulness in early diagnosis of neonatal infection whereas Smulian et al were skeptical [23]. Five studies [2,6,8,9,14] supported usefulness in early diagnosis of neonatal infection whereas Smulian et al were skeptical [23].…”

Section: Introductionmentioning

confidence: 99%

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Soluble intercellular adhesion molecule and C-reactive protein as early markers of infection in newborns

Hansen

Verder²,

Staun-Olsen³

2000

Journal of Perinatal Medicine

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In order to find a reliable early marker of infection in newborns a study with simultaneous determination of soluble Intercellular Adhesion Molecule-1 (sICAM-1) and C-Reactive Protein (CRP) was planned. Prospectively 90 babies < 5 days of age suspect of infection were included. Retrospectively this population was classified into an "infected" group (n = 45) and a "non-infected" group (n = 45). For each of these two groups we calculated the sensitivity, specificity and predictive values of sICAM-1 and CRP as early markers of infection. We determined the best cut-off level for sICAM-1 to be 300 micrograms/l and for CRP 5 mg/l. As a biochemical test for infection in the newborns the sensitivity and negative predictive value for CRP were 0.69 and 0.73 respectively. When sICAM-1 was added and CRP and s-ICAM-1 were used in combination the sensitivity improved significantly to 0.93, p < 0.01 and the negative predictive value improved to 0.92, p < 0.05. In normal 5-8 days old babies' sICAM-1 was significantly higher than at birth (cord blood), p < 0.0001. In conclusion, sICAM-1 and CRP in combination are better than CRP as a primary test for identification of infection in babies < 5 days of age.

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Section: Discussionsupporting

confidence: 90%