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

In order to find a reliable early marker of infection in newborns a study w ith simultaneous determination of soluble Intercellular Adhesion Molecule-1 (sICAM-1) and C-Reactive Protein (CRP) was planned. Prospectively 90 babie s < 5 days of age suspect of infection were included. Retrospectively this population was classified into an "infected" group (n = 45) and a "non-infe cted" group (n = 45). For each of these two groups we calculated the sensit ivity, specificity and predictive values of sICAM-1 and CRP as early marker s of infection. We determined the best cut-off level for sICAM-1 to he 300 mu g/l and for CRP 5 mg/l. As a biochemical test for infection in the newbo rns the sensitivity and negative predictive value for CRP were 0.69 and 0.7 3 respectively. When sICAM-1 was added and CRP and s-IChM-1 were used in co mbination 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 ol d 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 a s a primary test for identification of infection in babies < 5 days of age.