Inclusion Criteria:  All adult patients admitted to the afore-mentioned ICUs who were intubated within the previous 24 hours and were expected to receive MV support for more than 48 hours were recruited in the study.  Exclusion Criteria:  Patients with a clinical diagnosis of pneumonia at the time of admission and/or modified CPIS of 5 or greater. Patients who were previously intubated during the current hospital admission. Patients who had contraindications to suctioning such as severe hemoptysis, increased intracranial pressure, and cerebrospinal fluid leaks. Patients with pulmonary edema, ARDS, and those with atelectasis were also excluded from the study because of their pulmonary infiltrate disease pathophysiology. Patients known to be allergic to CHX were also eliminated from the study.