Value of microbiological rapid on-site evaluation in the diagnosis of pulmonary infection under bronchoscope
FANG Yu-kun1 LI Yu1 WANG Jian1 CHEN Jin-yao2 SONG Jia1 SHEN Qing1 WU Li-jun1 CHEN Qing-yong1▲
1.Department of Respiratory and Critical Medicine,the 903th Hospital of PLA,Zhejiang Province,Hangzhou 330000,China;
2.Department of Medical Biology,University of Sydney,Sydney 2050,Australia
Abstract：Objective To explore the value of microbiology rapid on-site evaluation (M-Rose) in the diagnosis of pulmonary infection under bronchoscope.Methods A retrospective analysis was made on 104 patients with bronchoscopic pulmonary infection in the 903th Hospital of PLA in Zhejiang Province from January to August 2018.The secretions of each patient under bronchoscope were evaluated on the spot by microbiology,and the samples were sent to the laboratory for testing at the same time,taking the report of the laboratory as the gold standard.The results of M-Rose and laboratory report are compared.Results Among the 104 cases,92 cases had definite etiology,12 cases had no definite etiology,including 55 cases of Gram-positive bacteria,17 cases of Gram-negative bacteria,3 cases of tuberculosis,4 cases of fungi,and 14 cases of mixed infection (including one case of fungus combined with bacterial infection of unknown etiology).A total of 94 cases of M-Rose had definite etiology,there were 10 cases with no definite etiology,including 56 cases of Gram-positive bacteria,17 cases of Gram-negative bacteria,3 cases of tuberculosis,5 cases of fungi,and 15 cases of mixed infection (including one case of tuberculosis with bacterial infection of unknown etiology,one case of fungus with bacterial infection without definite pathogen).There was no significant difference in the diagnosis rate between the two detection methods (P＞0.05).With the test results as the gold standard,the sensitivity and specificity of M-Rose were 100.00% and 90.91% respectively.The tuberculosis diagnostic accuracy of MRose was 100.00%,the fungus sensitivity of M-Rose was 80.00%,the specificity was 100.00%,and the overall diagnostic accuracy was 98.91%.The results of M-Rose in the diagnosis of pulmonary infection were in good agreement with the results of etiology in the laboratory (Kappa=0.907,P＜0.001).Conclusion M-Rose has a high diagnostic value for patients with pulmonary infection under bronchoscopy,which is helpful for the preliminary evaluation of the etiology of the patients with pulmonary infection,and can provide early treatment basis for the future clinical treatment.
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