I am having the same problem recently. No matter what I do, nebulize, don't nebulize, spit out before huff coughing, use AD, use aerobika, for the past five samples it's always the same. I've gotten the dreaded "the presence of 10 or more epithelial cells per low power field indicates contamination with oropharyngeal flora making the specimen unsuitable for processing". It's frustrating because my pulmonologist suspects that the achromobacter colonization that showed up in late 2022 but never caused problems, has finally had an impact given that I've been bringing up blood and am quite fatigued. She wants to me to take antibiotics but I'm really hesitant without knowing what bug I've got. Any additional suggestions would be greatly appreciated. And as a side note I almost never bring up mucous in the morning, but lots at the end of the day. I only use Severent diskus inhaler plus 7% saline.