Twelve patients with an endotracheal tube and a new infiltrate were assessed for differences in the bacteriologic information that could be obtained by routine tracheal suctioning (RTS), a double-lumen protected-sheath brush passed through a flexible fiberoptic bronchoscope (B-FFB), and suctioning through a flexible fiberoptic bronchoscope (S-FEB). Gram stains and cultures were performed on all specimens. There was 100% agreement for the culture results obtained by RTS and S-FEB. It is concluded that RTS obtains comparable information to that obtained by the more expensive and more personnel-intensive B-FFB.