PRCS (Protected Respiratory Catheter Specimen) - Protected Specimen Brush:
- Bronchoscopic technique with direct visualization
- Protected catheter design prevents upper airway contamination
- Quantitative culture: ≥10³-10⁴ CFU/mL diagnostic for VAP
- Higher specificity (~90%) but more invasive
- Requires expertise and equipment
Extation (Endotracheal Aspiration):
- Simple blind bedside procedure with suction catheter
- No visualization needed
- Higher diagnostic threshold: ≥10⁴-10⁵ CFU/mL
- Higher sensitivity (~70-90%) but lower specificity (~60%)
- Cost-effective and readily available 24/7
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