Title: a Program for Sustained Improvement in Preventing Ventilator Associated Pneumonia in an Intensive Care Setting

The manuscript has significantly improved after being revised. Most raised issues have now been clarified. Nevertheless, it needs some minor essential revisions, which are mentioned below: In the Abstract Results section: “We found VAP rates of 1.3 and 2.0 per 1,000 ventilator days respectively in 2009 and 2010, achieving zero incidence of VAP during 12 months, with a VAP bundle compliance over 90%” It is probably a sentence problem, but by reading this, it seems like you had a period of 12 months where there was no VAP, and in fact, there is no data to support this and I don't think it is what you mean... I suggest that you change the sentence to “...achieving zero incidence of VAP several times during 12 months, whenever VAP bundle compliance was over 90%” But in the end, it is only a suggestion and perhaps an interpretation issue (which may happen to another one reading the paper).