Inclusion Criteria:  Age >= 18 years  At risk of acquiring bacterial HAP or VAP during ICU stay, defined as meeting all of the following criteria:  expected or documented hospital length of stay of more than 48 hours admitted to the ICU  Exclusion Criteria:  Death is deemed to be imminent or inevitable during this hospital admission AND one or more of the patient, substitute decision maker or attending physician are not committed to full active treatment