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Sepsis is a clinical syndrome, the core of which is the disorder of the host's response to infection. Sepsis progresses to septic shock, which can lead to increased mortality, so early identification and standardized management are particularly important. Over the past 30 years, the definition of septic shock has gradually changed, with efforts to improve the identification and screening of early septic shock, and to emphasize the importance of organ dysfunction in patients with septic shock. The birth of the rescue systemic infection movement has played an important role in the management of septic shock patients. Although the cluster management of septic shock patients has reduced the overall mortality of septic shock patients, the management still faces many challenges. How to provide personalized treatment to patients, especially some controversial treatments, is still a major area for us to consider and explore.

Objective: This study aims to evaluate the value of microbial rapid on-site evaluation (M-ROSE) of sepsis, and septic shock caused by pulmonary infection., Patients and Methods: Thirty-six patients with sepsis and septic shock due to hospital-acquired pneumonia were analyzed. Accuracy and time were compared with M-ROSE, traditional culture, and next-generation sequencing (NGS)., Results: A total of 48 strains of bacteria and 8 strains of fungi were detected by bronchoscopy in 36 patients. The accuracy rate of bacteria and fungi was 95.8% and 100%, respectively. M-ROSE took an average of 0.34±0.01 hours, much faster than NGS (22h±0.01 h, p<0.0001) and traditional culture time (67.50±0.91 h, p<0.0001)., Conclusions: M-ROSE may quickly identify common bacteria and fungi, so it may be a useful method for the etiological diagnosis of sepsis and septic shock caused by pulmonary infection.