to the editor: Jain et al. report a laudable reduction in rates of MRSA transmission and infection after the institution of a bundled prevention program. It appears that the calculation of transmissions of MRSA did not exclude from the denominator the inpatient days associated with patients who were not at risk for acquisition of MRSA (i.e., patients who tested positive for MRSA on admission or who had a history of MRSA, a number that increased over time with active surveillance). If this is the case, then the reported relative reduction in transmission rates of 17% in the ICU and 21% in non-ICU areas may be inflated by the use of a denominator that includes both at-risk and already-colonized patients.1 Huskins et al.
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