Background: Ventilator-associated pneumonia (VAP) remains a common case of intensive care unite (İCU) and hospital morbidity and mortality despite advances in diagnostic techniques and manegment. One of most important point for such patients is identification of predictors for mortality in term for futher their modification and reduction of mortality rate.Objective: We aimed to determine the most important risk factors for short-term mortality in patients with VAP in mechanically ventilated patients Methods: This retrospective study was carried out from February 2014 to January 2019. One hundred twenty one adults patients with VAP maintained on mechanical ventilation for more than 48 h in our ICU department were enrolled in the study. VAP was diagnosed as new persistent pulmonary infiltrates on chest radiographs and a least two of following: (1) Fever of ≥38.3C(2) leukocytosis of ≥ 12.000/mm 3 and (3) purulent tracheobronchial secretions. Endotracheal aspirate (ETA) samples and blood samples of suspected case were collected and processed as per standard protocols. Results:The primary underlying diagnosis and comorbidities were acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in 42 patients, congestive heart failure in 32, neurological disease in 28, and renal disease in 19 patients. Gram-negative agents were the major of finding pathogen (Acinotebacter baumannii accounting for 37.1 %). This infection in 43 case (95.5%) was multi-dying resistant (MDR) pathogen and associated with significantly higher length of ventilation (LOV) and the length of ICU stay (LOS icu ) (p=0.01 respectively). Severe sepsis/septic shock, acute respiratory distress syndrome (ARDS), malnutrition, pulmonary complications such as pleural effusions and bilateral, multi-lobar lung infiltrates were most common findings in VAP patients which were associated with higher mortality (p<0.01) .Acinotebacter baumanii MDR pathogens was associated with higher mortality rate compare with other MDR pathogens (p<0.01) Conclusion:Ventilator-associated pneumonia is a serious ICU complication that is associated with increased in hospital mortality.In patients with VAP malnutrition ,severe sepsis/septic shock, ARDS, MDR Acinotebacter baumannii infection ,bilateral pulmonary infiltrates ,and underlying chronic obstructive pulmonary disease(COPD) are associated with increased risk in-hospital mortality in such patients. Identification of risk factor for in hospital mortality in such patents is important in term on further their modification and reduction of mortality rate

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Infrared spectroscopic ellipsometry (IRSE) is a powerful tool for the characterization of various types of organic and inorganic films. In application to protein films, IRSE can be utilized to detect structural changes, orientation of specific group, etc. Because of sensitivity, enhanced IRSE will be very useful to study protein thin films. Here we show that fibroin films on Al mirror display surface‐enhanced infrared spectroscopic ellipsometry (SEIRSE). AFM data indicate that nanoislands on the Al mirror are responsible for the plasmon‐enhanced mechanism. SEIRSE for fibroin films shows non‐uniform enhancement across the spectrum. Possible mechanisms of such enhancement are provided. Evidently, as proposed previously, at least two mechanisms, the electromagnetic (EM) and chemical, are expected to contribute to the enhancement. (© 2015 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)

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