Application of microbiological rapid on-site evaluation in respiratory intensive care units: a retrospective study

Background: To analyze the clinical value of microbiological rapid on-site evaluation (M-ROSE) in the respiratory intensive care unit (RICU) and its impact on the prognosis of critically ill patients. Methods: We retrospectively included patients who underwent bedside bronchoalveolar lavage in the RICU of Chinese People's Liberation Army (PLA) General Hospital between January 2017 and December 2020. The patients were divided into M-ROSE and control groups according to whether bedside M-ROSE was performed with to guide the treatment, and for control group, routine treatments were administrated based on all the clinical information. The basic information, treatment methods, test indicators, and prognostic evaluation of the patients were collected and analyzed. Results: A total of 242 patients were enrolled, including 130 patients in the M-ROSE group and 112 patients in the control group. The inflammatory indicators of the patients in the M-ROSE group decreased significantly faster after admission than those of patients in the control group, and the patients in the M-ROSE group used significantly more types of antibiotics [5 (3.0, 5.0)] than those in the control group [3 (2.0, 4.0)] (P<0.05). Among the patients who were on invasive mechanical ventilation, the mortality rate of the M-ROSE group was significantly lower than that of the control group (P<0.05). The coincidence rate of the M-ROSE results with metagenomic next-generation sequencing (mNGS) results was 66.2%, which was higher than the coincidence rate of other laboratory results. In addition, the M-ROSE reports were available significantly faster than the smear, culture, and mNGS results. Conclusions: M-ROSE has high diagnostic value for lower respiratory tract pathogens. The application of M-ROSE in the RICU can help to promote a decrease in patients' inflammation levels and reduce the mortality of patients on invasive mechanical ventilation.