A 52-year-old woman with acute respiratory distress syndrome (ARDS) secondary to pneumonia is on mechanical ventilation (FiO₂ 0.8, PEEP 12 cm H₂O). Despite optimization, her PaO₂ remains 65 mmHg and compliance is declining. The team suspects ventilator-associated pneumonia (VAP). Which investigation is most appropriate to confirm the diagnosis?
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