The trial design is a pilot observational feasibility study within three intensive care units at the Hamilton General Hospital, which is composed of both medical and surgical patient populations where waived consent has been confirmed and approved by the Hamilton Integrated Research Ethics Board. The study sample will include 50 patients over the age of 16 that will be mechanically ventilated for greater than 48 hours with no antibiotic use for the past 24 hours and meet the Johanson Criteria for Ventilator Associated Pneumonia (VAP) as the gold standard for diagnosis still remain controversial. This Johanson criteria maintains patients must have 2 out of three criteria to be enrolled in the study and that criteria includes either a leukocyte count >12,000/mm³ , Fever >38.0ºC and/or a new onset of purulent endotracheal secretions or change in the character of sputum. Chest x-rays for examination of a new or progressing infiltrate will be assessed but will not be used for initial inclusion criteria but possibly in the conclusions when attempting to differentiate VAP from VAT.