We appreciate the contribution of Lima et al to the discussion of this important issue. While their results appear different, it is important to appreciate the numerous differences in our methodologies when making that comparison. (1) While we both analyzed the incidence of MDR infections, Lima et al looked only at ICU populations, while we looked more broadly at all inpatient units (ICU and non-ICU). (2) Lima et al considered CRAB, while we looked at 5 pathogens, noting differences in CRAB and MRSA.