N-Myc and STAT Interactor is a Novel Biomarker of Severity in Community-Acquired Pneumonia: A Cohort Study

Abstract

Background: Community-acquired pneumonia (CAP) is among the deadliest infectious diseases. Severe CAP progresses rapidly and has a high mortality rate which requires early detection. N-myc and STAT interactor (NMI) is a novel biomarker involved in inflammatory diseases. Methods: Prospective observational analysis of patients with CAP. The NMI levels in serum of 394 CAP patients on admission were measured to assess the ability of NMI to assess clinical outcomes. The NMI levels in bronchoalveolar lavage fluid (BALF) of 37 CAP patients were also tested to identify severe and non-severe group.Results: The serum NMI levels in CAP patients with poor clinical outcomes were significantly higher (P < 0.001) than those without outcomes. The AUC of NMI to predict mortality was 0.91 (95% CI: 0.86-0.96), and that to predict ICU admission was 0.92 (95% CI: 0.88-0.97), significantly higher than that of other biomarkers such as PCT and CRP. The AUC of the new score systems (N-PSI and N-CURB65) to predict outcomes were significantly higher than the original score systems. Furthermore, the AUC of NMI in BALF was 0.93 (95% CI: 0.86-1.00) for predicting severe CAP. Conclusions: NMI is a novel effective biomarker for predicting CAP severity.