Soluble intercellular adhesion molecule-1 (slCAM-1) for early diagnosis of neonatal infections.

We investigated the validity of circulating soluble intercellular adhesion molecule-1 (slCAM-1) as an early immunological marker of neonatal sepsis as compared to C-reactive protein (CRP), immature to total neutrophils ratio (IlT) and blood culture assays. The study included 28 full term neonates with clinical manifestations of sepsis, 10 of them had suspected sepsis "Group I" with negative blood culture, positive CRP during 1st week of life and one or more risk factors for infections. The other 18 neonates had proven sepsis "Group II"; with positive blood culture and positive CRP. 14 normal age and sex matched controls "Group III" were also included. Serum slCAM-1 concentrations (ng/ml) were measured using enzyme linked immunosorbent assay (ELISA) in two successive blood samples; before (S1) and one week after (S2) the start of antibiotics respectively. The mean value of I/T ratio was significantly higher in both SI and S2 (P<0.05; P<0.001 respectively) in septic neonates compared with controls. In addition, a significant difference (P<0.05) was detected in S2 between mean CRP levels in group I (9.6+/-15.7 mg/dl) and group II (17.3+/-30.0 mg/dl). The mean values of slCAM-1 in (Sl) of septic groups I and II (445.7+/-138.5 and 512.8+240.9 ng/ml respectively) were significantly higher (P<0.05) than those of control group (364.0+/-67.4). In contrast, in (S2) insignificant differences were detected between both groups (392.6+/-149.8 and 420.0+/-184.7 respectively) and controls. A positive correlation was revealed between CRP and slCAM-1 values in (Sl) (r=0.3, P<0.05). Positive correlations were also detected between slCAM-1 levels and leukocytic counts (r=0.3, P<0.05) and CRP (r=0.5, P<0.001) in (S2) while, negative correlation was detected between slCAM-1 levels and platelet counts (r= -0.5, P<0.001). In conclusion, serum concentration of ICAM-1 is a potential marker for diagnosis of neonatal sepsis at its early stages.