Predictive value of soluble immunological mediators in neonatal infection

Clin Sci (Lond). 1994 Aug;87(2):165-71. doi: 10.1042/cs0870165.


1. Infection in the neonatal period is difficult to diagnose and is a significant cause of morbidity and mortality in preterm infants. 2. We investigated prospectively the predictive value of plasma measurement of bacterial endotoxin (lipopolysaccharide), tumour necrosis factor-alpha, interleukin-6, interleukin-8, intercellular adhesion molecule-1 and C-reactive protein in 60 consecutive newborn infants suspected of having neonatal infection. Plasma samples were taken at the time of acute clinical deterioration. Sixty-two cord blood samples were studied as controls taken at elective Caesarean section. 3. Forty-three infants had confirmed infections, 25 with positive blood cultures. Tumour necrosis factor-alpha and bacterial endotoxin levels were not significantly elevated over controls, whereas interleukin-6, interleukin-8 and intercellular adhesion molecule-1 levels were all significantly increased in the infected group compared with controls (all P < 0.001). 4. Increased plasma intercellular adhesion molecule-1 levels were a highly sensitive (88%) indicator of clinical infection and were independent of C-reactive protein. Use of these two assays in combination improved the diagnostic sensitivity to 95% and gave a negative predictive value of 97%. addition of interleukin-6 or interleukin-8 measurements failed to further significantly enhance the prediction of infection. 5. Measurement of intercellular adhesion molecule-1 level may have a clinical role in rapidly confirming, or predicting, the likely diagnosis in cases of suspected neonatal infection.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Infections / blood
  • Bacterial Infections / diagnosis*
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Cesarean Section
  • Female
  • Fetal Blood / chemistry
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / blood
  • Infant, Premature, Diseases / diagnosis*
  • Intercellular Adhesion Molecule-1 / blood*
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Lipopolysaccharides / blood
  • Predictive Value of Tests
  • Pregnancy
  • Prospective Studies
  • Sensitivity and Specificity
  • Tumor Necrosis Factor-alpha / analysis


  • Biomarkers
  • Interleukin-6
  • Interleukin-8
  • Lipopolysaccharides
  • Tumor Necrosis Factor-alpha
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein