Nocardia

BAL
○ Pass bronchoscope transnasally or transorally (if patient is not intubated) or via endotracheal tube (if patient is intubated). Instill a large volume of 0.85% sterile saline (nonbacteriostatic) into the airway lumen. Discard the initial fluid recovered (likely contaminated). Collect remaining fluid in a clean, sterile container via suction.

Bronchial brushings/washing
○ Instill brush to collect cellular material from esophageal wall. Place protected brush sample in sterile container with 1 mL of saline.
○ If collecting washings, pass bronchoscope transnasally or transorally (if patient is not intubated) or via endotracheal tube (if patient is intubated). For washings, inject aliquots of approximately 20 to 30 mL of 0.85% sterile saline (nonbacteriostatic) for adults, or 5 mL for children. Suction washings into a sterile container.

Sputum/tracheal aspirate
○ Collect sputum by expectoration or by tracheal aspiration in sterile container.
○ For endotracheal aspirates, collect aspirated material using a NEW sterile catheter or in-line catheter and aspirate material from the trachea using a syringe or suction device

Pus and abscess material
○ Pus from an abscess should be collected using a sterile swab in Amies transport medium.
○ Abscess aspirates should be collected aseptically through decontaminated skin using a syringe and needle and placed in a sterile container and submitted to the laboratory ASAP.