Intercellular adhesion molecules and mortality for sepsis in infants younger than 1 year of life

Area of Science:

• Pediatric critical care medicine
• Neonatology
• Immunology

Background:

• Adhesion molecules are linked to sepsis severity and survival in adults.
• Limited research exists on adhesion molecules in infant sepsis, especially using international criteria.
• Understanding predictors of sepsis outcome in infants is crucial for timely intervention.

Purpose of the Study:

• To investigate if adhesion molecules (ICAM-1, VCAM-1, E-selectin) measured in the first 7 days of illness can predict sepsis outcome and severity in infants.
• To identify early biomarkers for sepsis mortality in young children.

Main Methods:

• Prospective study involving 88 infants with sepsis and 30 controls.
• Measurement of soluble intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, and E-selectin at days 1, 3, and 7 post-diagnosis.
• Primary outcome measure was 10-day mortality.

Main Results:

• Sepsis patients exhibited higher ICAM-1, VCAM-1, and E-selectin levels compared to controls.
• No significant association was found between adhesion molecule levels and sepsis severity.
• Mortality occurred in 10.2% of infants; increased ICAM-1 (>250 ng/mL from day 1-3), amine count, and baseline sepsis severity predicted mortality.

Conclusions:

• Intercellular adhesion molecule (ICAM)-1 levels, amine count, and initial sepsis severity are significant predictors of 10-day mortality in infants under one year with sepsis.
• Specific patterns of adhesion molecules did not emerge as distinct indicators in non-survivors.
• These findings highlight potential biomarkers for risk stratification in infant sepsis.