Aim of the study: Was to examine the potential diagnostic value of serum soluble intercellular adhesion molecule-1 (s.ICAM-1) and highly sensitive CRP (hs-CRP) in the setting of neonatal intensive care unit.
Methods: 50 consecutive serum samples were taken from 50 infants undergoing sepsis work up in a neonatal intensive care unit (30 neonates as study group and 20 neonates as control group) clinical diagnosis was established in prospective manner, blind to the result of study measurement. Infants were classified by an experienced paediatrician as infected or not infected. Classification was based on clinical presentation, routine laboratory and radiological investigations. The infected group were sub-classified as (a) culture positive infection (b) culture negative infection. s.ICAM-1 and hs-CRP levels were determined from stored serum samples after diagnosis was stablished and after 2-3 weeks of antimicrobial therapy. Further subgroup analysis of results was undertaken according to early or late onset of infection and preterm or term status. Statistical analysis utilized Mann Whitney U test and ROC curve analysis.
Results: There were significantly increased serum levels of s.ICAM-1 and hs-CRP in infected infants compared with non infected infants (p=0.001) and infected infants after 2-3weeks of antimicrobial therapy (p=0.001). ROC curve analysis indicated area under the curve values of 0.86 (s.ICAM-1) and 0.63 (hs-CRP) .ROC curve analysis also defined optimum diagnostic cut off level for each measurement, however further studies are required to elucidate this finding
|
