Given the invasive nature and high incidence of complications with techniques such as lung biopsy and percutaneous needle aspiration, these have now been replaced by safer methods such as endotracheal aspiration (ETA), bronchoscopic bronchoalveolar lavage (BAL), protected sampling brushing (PSB) and non-bronchoscopic methods such as blind BAL and blind bronchial aspirates (BBA) as approaches for the definitive diagnosis of VAP (8, 12). The ETA is the most widely used sampling technique in ventilated patients (13). This technique is known to have a high sensitivity but also has a high false positive rate and correlates poorly to actual pathogen due to respiratory tract colonization (14). Invasive bronchoscopic sampling techniques like bronchoscopic BAL and PSB are currently considered as the reliable sampling techniques in adult ICU to recover organism from the lower respiratory tract (15) and have high sensitivity and specificity (16). The usefulness of these techniques in routine clinical practice is, however, hampered by the potential risks of bronchoscopy, the unavailability of equipment and trained personnel on a 24-hour basis in many critical care facilities and the associated cost.