[Advances in early bedside etiological diagnosis of severe pneumonia]

The case fatality rate of severe pneumonia remains high, early and accurate etiological diagnosis is a prerequisite for precision antimicrobial therapy. Conventional culture techniques are limited by long turnaround times and low positivity rates. In recent years, novel detection systems such as microbiological rapid on-site evaluation(M-ROSE), point-of-care immunoloassays, multiplex PCR, and metagenomic sequencing have advanced rapidly, markedly shortening the time to pathogen identification. The integration of rapid detection assays for antimicrobial resistance genes has further facilitated precision antimicrobial therapy. Multi-omics analysis integrating the pathogen spectrum with host immune response status helps distinguish colonization from infection, thereby helping prevent antibiotic overuse. This article reviews techniques for pathogen and antimicrobial resistance gene detection together with strategies to distinguish colonization from infection to inform rapid bedside etiological diagnosis in severe pneumonia.