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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Harris raises an important point for US hospitals. However, incentives for hospitals differ, and our institution's decision to invest in screening was not driven by a desire to protect reimbursement from Swiss insurance companies, but rather an attempt to improve patient safety and reduce the overall cost burden of MRSA.

The letters by Dr Salgado and colleagues and Drs Jarvis and Muto raise methodological limitations that were discussed in our study. In contrast to the simultaneously published time-series analysis by Robicsek et al,¹ our study focused on screening of patients in surgical wards and was performed in a setting with low MRSA infection rates, a preexisting screening and decolonization policy for known carriers, and compliance with hand hygiene recommendations markedly above usual standards,² thus making it less likely to observe an added effect of general screening. Similar to our findings, a recent cluster-randomized crossover trial from the . . . [Full Text of this Article]

Stephan Harbarth, MD, MS
stephan.harbarth@hcuge.ch

Didier Pittet, MD, MS
Infection Control Program
University of Geneva Hospitals and Medical School
Geneva, Switzerland

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