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.
Nasopharyngeal swab
○ Insert tip of swab into nostril aiming along the floor of nasal cavity until posterior wall of nasopharynx is reached. Resistance will be felt when reached. Rotate swab for 10-30s. Place swab into transport medium and close tube. Repeat collection with second nostril.
Pleural fluid
○ Decontaminate skin. Insert needle into pleural space, aspirate fluid into syringe OR collect pleural fluid directly from drain if chest tube has been inserted to drain pleural space. Transfer specimen (min volume 1 mL) into sterile, leakproof container
Throat swab:
○ Collect the specimen using a clean, sterile swab by swabbing the posterior oropharynx vigorously and placing it in universal transport medium.
Tissue (Respiratory tract)
○ Collect 5-10 mm3 tissue aseptically using surgical technique. Place in a clean, sterile container with a small amount of sterile saline.