Value of examining buffy coats for intragranulocytic micro-organisms in patients with fever.

To determine the significance of the presence of intragranulocytic micro-organisms in the blood buffy coat in patients with suspected infection, buffy coat examination and blood cultures were simultaneously performed in 455 consecutive patients with fever. There was no general correlation between the finding of intragranulocytic micro-organisms in the buffy coat and positive blood cultures. Patients with persistent bacteraemia and sterile blood cultures were, however, shown to have persistently positive buffy coat findings on repeated examination. These patients, who had culture-negative endocarditis or catheter-associated infections, had sterile blood cultures because of antibiotic treatment. Repeated positive findings in the buffy coat may therefore be valuable in detecting patients with persistent bacteraemia, but sporadic findings of micro-organisms in the buffy coats of acutely ill patients seem to have little diagnostic value.     

Clinical and microbiological efficacy of single dose cefuroxime prophylaxis for dental surgical procedures.

In a prospective controlled randomised trial of 59 patients the effect of a single dose of cefuroxime before multiple tooth extractions on the clinical findings and occurrence of bacteraemia was studied. In one group 1.5 g cefuroxime was administered intravenously 10 min before start of surgery. A total of 118 blood samples were collected after 10 and 40 min. The cefuroxime group had a significantly lower rate of bacteraemia (33%) compared with the control group (86%). The predominant bacteria were gram-positive cocci. Fifty four different strains of bacteria were isolated, of which most were susceptible to cefuroxime. However seven strains which were susceptible to cefuroxime in vitro, were isolated from blood cultures of the treated group. Serum concentrations of cefuroxime ranged from 52.3 to 141.6 mg/l at 10 min and 32.6 to 91.8 mg/l at 40 min with a mean of 78.6 and 55.1 mg/l respectively. The only other factor which had a significant influence on the rate of bacteraemia was the number of extracted teeth. Oral hygiene and periodontal status did not significantly affect bacteraemia. There were no wound infections in any of the groups. During these dental interventions, sufficient plasma levels of antibiotic prevented bacteraemia. Selected patients might benefit from single-dose-prophylaxis with cefuroxime in preparation for dental surgery.     

Staphylococcus aureus bacteraemia with known sources

Meticillin-resistant Staphylococcus aureus (MRSA), both hospital-acquired and community-acquired MRSA (CA-MRSA) strains, have increased in frequency in the last few years, reaching epidemic dimensions. This review discusses several clinical forms of staphylococcal infection leading to bacteraemia in a high proportion of cases. Staphylococcal (MRSA) bacteraemic pneumonia is predominantly seen in hospital-acquired pneumonia and ventilator-associated pneumonia, reaching a frequency of 8.4% of all bacteraemias, 30% of all nosocomial bacteraemias and 68% of all bacteraemias of patients hospitalised in Intensive Care Units. In patients with CA-MRSA pneumonia, the rate of bacteraemia is as high as 62%. Whereas in nosocomial bacteraemic pneumonia blood cultures become positive on the ninth day of pneumonia, in CA-MRSA bacteraemic pneumonia positive blood cultures appear early in the course of the infection. The pneumonia has a stormy course with the development of abscesses, empyema and extensive pulmonary damage. Vertebral osteomyelitis commonly occurs during intravenous catheter use, causing local thrombophlebitis that will seed to vertebral bodies and disks and may cause secondary sustained bacteraemia. Non-vertebral osteomyelitis is also on the increase, with a frequency that has doubled in recent years, mainly due to MRSA. Patients with haematological malignancies are particularly prone to this complication, usually following line infections. Epidural abscess is the most serious consequence of staphylococcal bacteraemia, leading to permanent neurological damage if not diagnosed early enough.     

Open study of teicoplanin in gram-positive infections

Eighteen patients with documented Gram-positive infections which included osteomyelitis, prosthetic infections, endocarditis, skin and soft tissue, and urinary tract infections were treated with teicoplanin. The organisms involved included Staphylococcus aureus (15 isolates of which six were methicillin-resistant-MRSA), Staphylococcus epidermidis (two), Streptococcus faecalis (one) and Streptococcus milleri (one). Clinical success occurred in all seven patients with skin and soft tissue Streptococcus milleri (one). Clinical success occurred in all seven patients with skin and soft tissue infections (with bacterial persistence in three out of the seven), in three patients with bacteraemia endocarditis, and in one of the three patients with chronic osteomyelitis. In four patients with prosthetic bone and joint infections, clinical improvement followed removal of prostheses. Adverse effects occurred in two patients and these included one patient with a rise in serum aspartate aminotransferase and bilirubin and one patient with a rise in blood urea, both of which returned to within normal limits on discontinuing the drug. The study showed that teicoplanin is a safe and effective antistaphylococcal agent.     

老年患者无痛胃镜和无痛肠镜检查的I晦床探析

目的研究分析老年患者无痛胃镜和无痛肠镜检查的临床效果,以及探究这两种检查方法的科学性和可行性。方法选择我院从2011年9月至2012年9月收治的400例老年患者,将所有患者随机分为四组,无痛肠镜组、无痛胃镜组、普通肠镜组和普通胃镜组,每组各100例患者。观察对比两组患者的生命体征、血氧饱和度以及不良反应情况。结果普通胃镜组和普通肠镜组的血压升高和心率增快的患者明显高于无痛胃镜组和无痛肠镜组,二者之间的差异具有统计学意义,P〈0．05。无痛胃镜组和无痛肠镜组的不良反应情况明显优于普通胃镜组和普通肠镜组,二者之间的差异具有统计学意义,P〈0．05。结论老年患者采用无痛胃镜和无痛肠镜具有比较好的检查效果,安全性和舒适度都比较好。     

Antibiotic prophylaxis for ERCP: a comparison of oral ciprofloxacin with intravenous cephazolin in the prophylaxis of high-risk patients

Background:

Cholangitis and septicaemia are serious complications of endoscopic retrograde cholangiopancreatography (ERCP). They occur mainly following therapeutic ERCP in the setting of an obstructed biliary system. The optimum prophylactic antibiotic regimen in such patients is not yet defined but usually depends on intravenous agents.

Aim:

To compare the efficacy of oral ciprofloxacin with intravenous cephazolin.

Methods:

One hundred and fifty patients at high risk from septic complications were randomized prospectively to either oral ciprofloxacin (750 mg b.d.) or intravenous cephazolin (1 g b.d.), commenced at least 90 min prior to the ERCP and continued for 3 days. Bacteriological cultures were taken from bile during the procedure and from blood both immediately and at 24 h post-procedure.

Results:

There were no significant differences between the two treatment groups in the pre-ERCP clinical or radiological findings or in the types of procedure performed. One patient did not undergo an ERCP and was excluded from the final analysis. Of the 77 patients in the ciprofloxacin group there were no positive blood cultures and one positive culture from a nasobiliary drain. Two out of the 72 cephazolin patients had positive blood cultures immediately post-ERCP; one of these two patients and one other cephazolin patient had positive bile cultures. There were no cases of cholangitis or septicaemia in the ciprofloxacin group and three cases in the cephazolin group. One patient from each treatment group died within the 7-day study. Adverse drug reactions were minimal and none of the different clinical outcomes in the two groups reached statistical significance.

Conclusion:

Oral ciprofloxacin is a cost-effective prophylactic agent for high-risk ERCP.

     

肠镜下高频电切术治疗结肠息肉的临床疗效观察

目的探讨肠镜下高频电切术治疗结肠息肉的临床疗效。方法为了探讨肠镜下高频电切术治疗结肠息肉的临床效果,本研究于2008年2月至2012年2月对收治的结肠息肉患者采取肠镜下高频电切术治疗,观察其疗效及并发症。结果本组159枚息肉均在肠镜下经高频电圈套切除法成功切除,术后经过复查发现无1例残留,随访亦未见复发,临床有效切除率达100.00%。159枚息肉均在肠镜下经高频电圈套切除术后共有19枚发生出血,发生率为11.95%,其中14枚为早期出血,另外5枚为延迟性出血,所有出血病例经过止血治疗后均成功止血;无1例发生穿孔。结论内镜下行高频电切除术治疗结肠息肉安全、可靠、有效、创伤小、经济实惠、疗效确切、患者不论年龄大小均可接受的治疗方法,如术中或术后发生出血,则应积极进行内镜下治疗,少量渗血和搏动样出血通过药物喷射及电凝止血效果好,可以作为治疗结肠息肉的首选方法,对减少大肠癌的发生有重要的价值。     

A quantitative immunochemical faecal occult blood test is more efficient for detecting significant colorectal neoplasia than a sensitive guaiac test

BACKGROUND: The sensitive guaiac faecal occult blood test, Haemoccult SENSA (HOS; Beckman Coulter, Fullerton, CA, USA), is our standard screening test for significant colorectal neoplasia. We evaluated an automatically-developed, quantified human haemoglobin immunochemical faecal test, OC-MICRO (Eiken Chemical Co., Tokyo, Japan), to improve test specificity and so reduce the colonoscopy burden. AIM: To compare guaiac faecal occult blood test and immunochemical faecal test diagnostic efficacy and costs for identifying significant neoplasia. METHODS: Colonoscopies were performed on patients who prepared three daily guaiac faecal occult blood tests with or without immunochemical faecal tests. RESULTS: Total colonoscopy was performed on 151 subjects who prepared both guaiac and immunochemical faecal tests (group 1) and the positive predictive values (PPV) were also compared to those of 162 subjects undergoing colonoscopy for positive guaiac faecal occult blood tests (group 2). In group 1, comparative sensitivity, specificity, and PPVs for significant neoplasia with guaiac faecal occult blood test were 75%, 34%, and 12% (PPV, 18% for group 2) and with immunochemical faecal test were 75%, 94% and 60% (P < 0.01 for specificity). The number of colonoscopy examinations needed to detect a significant neoplasm because of positive faecal occult blood tests was six to eight with HOS and two with OC-MICRO at 21-31% the cost of evaluating a positive guaiac faecal occult blood test. CONCLUSION: An immunochemical faecal test maintains the high sensitivity of guaiac faecal occult blood test, but significantly reduces the colonoscopy burden and screening costs.     

粪便隐血试验在大肠癌筛检中的作用

目的 :分析粪便隐血在大肠癌发生、发展中的规律 ,进而发挥粪便隐血检测在大肠癌诊断中的作用。方法 :收集以北京地区为主的 2 7所医院 2 0 0 2年 4月 1日～ 2 0 0 3年 4月 1日内镜 (病理 )诊断的大肠癌患者 5 97例 ,粪便免疫隐血条形试纸检测粪便隐血 ,分析粪便隐血与癌胚抗原 (CEA)、肉眼血便、肿瘤部位、病理分型及分期的相关性。结果 :44 8例有隐血结果 ,其中阳性 3 64例 ,阳性率为 81 2 5 % ;隐血试验对大肠癌检出的阳性率为 79 75 % ,CEA检出率为 45 45 % ;3 0 8例肉眼血便中粪便隐血试验阳性率为88 96% ,14 0例无肉眼血便的患者粪便隐血试验阳性率为 64 2 9% ;左半结肠癌粪隐血阳性率为 81 3 9% ,右半结肠癌为 81 60 % ;中、高分化腺癌隐血阳性率为 81 3 5 % ,类癌阳性率为 3 3 3 3 % ;Duck’sA、Duck’sB粪隐血阳性滤为 78 48% ,Duck’sC、Duck’sD期粪隐血阳性率为 81 86%。结论 :粪便隐血试验仍是大肠肿瘤筛检的重要手段 ,且阳性率优于CEA ;隐血试验操作时要参考有无肉眼血便 ;隐血试验的阳性与否与发病部位及分期无关 ,但与大肠癌的病理分型有关。     

Can quantification of faecal occult blood predetermine the need for colonoscopy in patients at risk for non‐syndromic familial colorectal cancer?

BACKGROUND: Patients at risk for non-syndromic (Lynch or polyposis) familial colorectal neoplasia undergo colonoscopic surveillance at intervals determined by clinically ascertained protocols. The quantitative immunochemical faecal occult blood test for human haemoglobin is specific and sensitive for significant colorectal neoplasia (cancer or advanced adenomatous polyp). AIM: To determine immunochemical faecal occult blood test efficacy for identifying significant neoplasia in at-risk patients undergoing elective colonoscopy. METHODS: We retrospectively identified consecutive at-risk patients who provided three immunochemical faecal occult blood tests before colonoscopy. Quantitative haemoglobin analysis was performed by the OC-MICRO automated instrument using the 100 ng Hb/mL threshold to determine positivity. RESULTS: In 252 at-risk patients undergoing colonoscopy; five had cancer, 14 an advanced adenoma and 46 a non-advanced adenoma. The immunochemical faecal occult blood test was positive in 31 patients (12.3%). Sensitivity, specificity, positive and negative predictive values for cancer were: 100%, 90%, 16% and 100%, and for all significant neoplasia: 74%, 93%, 45% and 98%. With 88% fewer colonoscopies, all colorectal cancers and 74% of all significant neoplasia would have been identified by this one-time immunochemical faecal occult blood test screening. CONCLUSIONS: A sensitive, non-invasive, interval screening test might be useful to predetermine the need for colonoscopy in this at-risk population and minimize unnecessary examinations. This favourable retrospective evaluation will be extended to a prospective study.     

Comparison of home occult blood tests and interaction of tests with ibuprofen

The interaction of ibuprofen with home tests for occult blood was evaluated, and the accuracy of these tests was determined by validating the results with a specific quantitative assay of stool blood. Three home occult blood tests were evaluated: Early Detector, Fleet Detecatest, and CS-T Coloscreen Self Test. Fourteen men 19 to 35 years of age were instructed on how to use the tests and to record each day their dietary intake and stool consistency, the color of test control areas, the results, and the times of ibuprofen administration. The study consisted of a control period (days 0-5) and short-term (days 6-9) and long-term (days 10-14) ibuprofen periods. Each subject took two 200-mg tablets of ibuprofen three times daily beginning on day 6 and ending on day 14. During each study period, one stool sample was collected on each of three consecutive days. All three tests were performed on each sample, in addition to specific quantitative analysis with HemoQuant. All samples in the control period were negative for occult blood. Three positive results were reported by subject 4 in the short-term ibuprofen period, one with Fleet Detecatest and two with Early Detector. Subject 6 reported two positive Fleet Detecatest results and three positive Early Detector results during the long-term drug period. No positive results were detected with CS-T Coloscreen Self Test. The HemoQuant values showed that Early Detector produced one false-negative and two false-positive results.(ABSTRACT TRUNCATED AT 250 WORDS)     

Early antibiotic treatment of pseudomonas aeruginosa colonisation in cystic fibrosis: a critical review of the literature

Aim To assess the evidence supporting early antibiotic treatment in asymptomatic cystic fibrosis (CF) patients colonised by Pseudomonas aeruginosa (PA).Methods We carried out a computerised (Medline, Embase) and hand search of journals for suitable publications. All English-language clinical studies regarding the efficacy of early antibiotic treatment on PA colonisation in asymptomatic patients were considered. Each eligible publications fitting these criteria were assessed for the following outcome measures: frequency of positive PA cultures; serum level of precipitating antibodies; lung function; survival; number of hospitalisations; adverse effects and resistance to antibiotics.Results Of the 11 studies eventually considered, 3 were randomised—2 versus placebo— and 8 were cohort studies—2 of which had historical controls. Overall, 309 patients (population range 7–91 patients) were recruited. There was a high variability between the individual studies for age, outcome measures, duration of follow-up (1 to 44 months) and treatment (three studies used only aerosol tobramycin, one colistin, four aerosol colistin plus oral ciprofloxacin, one used intravenous treatment and two miscellaneous therapy). An overall evaluation indicated that early antibiotic treatment can reduce the number of positive cultures and the anti-PA antibody titre. In one study, FEV1 was better in the treated group (oral ciprofloxacin and nebulised colistin) than in historical controls, while in one placebo-controlled trial, no effect on lung function was shown after 1 year of tobramycin inhalation. Collateral effects and bacterial resistance were not increased. The short follow-up did not allow definite conclusions with regard to the long-term progression of respiratory insufficiency or survival.Conclusions Evidence was found that antibiotic treatment can reduce the rate of positive cultures and of anti-PA antibody titres in asymptomatic CF patients with newly isolated PA. Different therapeutic options have not been directly compared: a multi-centre comparative study needs to be carried out.     

A sensitive guaiac faecal occult blood test is less useful than an immunochemical test for colorectal cancer screening in a Chinese population

BACKGROUND: Colorectal cancer screening by guaiac faecal occult blood test has been shown to reduce the incidence and mortality of colorectal cancer in Western populations. The optimal faecal occult blood test, whether guaiac or immunochemical, for colorectal cancer screening in the Chinese population remains to be defined. AIM: To compare the performance characteristics of a sensitive guaiac-based faecal occult blood test (Hemoccult SENSA) and an immunochemical faecal occult blood test (FlexSure OBT) in a Chinese population referred for colonoscopy. METHODS: One hundred and thirty-five consecutive patients who were referred for colonoscopy and who met the study inclusion criteria took samples for the two faecal occult blood tests simultaneously from three successive stool specimens, with no dietary restrictions. All tests were developed and interpreted by a single experienced technician who was blind to the clinical diagnosis. The sensitivity, specificity and positive predictive value for the detection of colorectal adenomas and cancers were estimated for the two tests. RESULTS: The sensitivity, specificity and positive predictive value for the detection of significant colorectal neoplasia (adenomas > or = 1.0 cm and cancers) were 91%, 70% and 18% for Hemoccult SENSA and 82%, 94% and 47% for FlexSure OBT. The specificity and positive predictive value were significantly higher for FlexSure OBT than for Hemoccult SENSA (P < 0.001 and P = 0.016, respectively). Combining the positive results from both faecal occult blood tests did not improve the accuracy. CONCLUSION: The positive predictive value of the immunochemical faecal occult blood test for the detection of significant colorectal neoplasia was 29% better than that of the sensitive guaiac-based test. This may relate to the Chinese diet and requires further study. The poor specificity of the sensitive guaiac-based test, without dietary restriction, makes it less useful for colorectal cancer screening in a Chinese population.     

南昌市部分人群大肠癌与息肉临床特点调查分析

目的探讨南昌市居民大肠癌与息肉的临床特点。方法选取我院肠道门诊2005年1月至2007年12月就诊的腹泻病例经结肠镜检与病理确诊的大肠癌、息肉患者进行总结分析。结果3年来5073例腹泻患者中共行结肠镜检873例,确诊的大肠癌75例,大肠息肉114例。大肠癌检出率为8.6%,平均发病年龄为64.01岁,好发病年龄为51～70岁,占90.67男∶女为1.6∶1;大肠息肉患者的检出率为13.1%,平均年龄为44.15,男性以61～70岁发病率最高,占18.42%,男∶女为1.65∶1;直、乙结肠是大肠癌与息肉的最常见部位,分别占74.67%和68.42%。结论大肠癌与息肉男性多于女性,直肠和乙状结肠是最常见发生部位。50岁以上的中老年人是大肠癌的高危人群。     

Bacteremia following cardiac arrest and cardiopulmonary resuscitation

After but of hospital CPR thirty three resuscitated patients were studied for bacteremic complications. Thirteen patients (39%) had two or more positive blood cultures during the twelve hours following CPR. Source of superinfection was a central venous catheter in one case (staphylococcus). The twelve other bacteremic patients had fetid diarrhea a few hours after admission. The same organism were found in blood and faeces (streptococcus D, Escherichia coli, Pseudomonas aeruginosa, acinetobacter, enterobacter). Mesenteric ischemia caused by a low cardiac output may explain the diarrhea and the intestinal origin of the septicemia. All patients (12 cases) with diarrhoea and bacteremia died. Patients who recovered without neurologic sequelae (4 cases) had never been septic and never had diarrhea.     

The Role of Clarithromycin in the Prophylaxis of Disseminated Mycobacterium Avium-Intracellulare Infection in Patients with AIDS

Clarithromycin is a first-line agent in the treatment of disseminated disease due to Mycobacterium avium-intracellulare (dMAC) in patients with the acquired immunodeficiency syndrome, and its role in dMAC prophylaxis is nearing definition. Fifteen abstracts described clinical outcomes when clarithromycin was given in various dosages as monoprophylaxis or in combination with other agents. Patients totaled 1063, the majority of whom had CD4+ counts of 100 cells/mm³ or below. In one study, MAC disease occurred in 4.5% of 343 clarithromycin-treated patients compared with 12.6% of 341 receiving placebo (p<0.001). The remaining studies combined to report only two positive blood cultures, one positive sputum culture, and one positive culture of unidentified origin during their respective study periods. Gastrointestinal intolerance caused discontinuation of therapy in 21 (2.9%) of 722 patients receiving clarithromycin. Clinical evaluations show that the drug decreases the risk of dMAC, prolongs survival, and is well tolerated. Controlled clinical trials continue.     

Evaluation of the genotoxicity and cytotoxicity of fexofenadine in cultured human peripheral blood lymphocytes

Fexofenadine (FXF) is a new non-sedating antihistamine used in the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria. Studies on FXF genotoxicity and cytotoxicity in cultured human peripheral blood lymphocytes have not been reported so far. Therefore, the present study is the first report investigating the genotoxic and cytotoxic effects of FXF in cultured human peripheral blood lymphocytes in vitro. Cultures were treated with FXF at three concentrations (50, 100 and 150 μg/ml) for 24 and 48 h. Endpoints analyzed included: mitotic index (MI), nuclear division index (NDI), chromosomal aberrations (CA) and micronucleus (MN) assay. Mitomycin C (MMC) was used as a positive control. The results of CA and MN assays showed that FXF was not genotoxic at all the concentrations tested, meanwhile MI and NDI results showed dose-dependent decrease and significant differences were found for at least one concentration. In conclusion, the results of this study suggest that FXF has a cytotoxic effect but not genotoxic effect on human peripheral blood lymphocyte cultures. Further cytogenetic studies, especially about the cell cycle kinetics of FXF are required to elucidate the decreases in dividing cells, and biomonitoring studies should also be conducted with patients receiving therapy with this drug.     

结核杆菌复苏促进因子在分枝杆菌培养中的作用观察

目的 探讨结核杆菌复苏因子(TB-RPF)在结核患者标本的分枝杆菌培养中的作用.方法 收集疑似结核患者的痰液42例,支冲液8例,胸腔积液25例,经4%NaOH液化处理后用PBS洗涤并悬浮菌体,每份标本分设对照组和RPF组,按照两组各0.5 ml菌液量接种于MGIT培养管.对照组培养基采用含Middlebrook7H9的...     

Treatment of chronic bacterial prostatitis with ciprofloxacin

Thirty two patients with proven chronic bacterial prostatitis were treated with ciprofloxacin 500 mg twice daily orally for four weeks. The causative organisms, cultured from prostatic fluid wereEnterobacteriaceae (19 patients), enterococci (9), staphylococci (4), streptococci (3), non-fermentative Gram-negative rods (2) and anaerobic bacteria (9). Nineteen patients had pure cultures, 13 mixed cultures. The susceptibility of all organisms to ciprofloxacin, sulfamethoxazole, trimethoprim and doxycyclin was determined by agar dilution. The effect of therapy was measured by clinical parameters and by repeated cultures of prostatic fluid during and after therapy upto six months. Clinical cure (at one month after therapy) was obtained in 22 patients, improvement in seven; two patients dit not respond, one patient had to stop during therapy because of severe nausea. No other side effects were noted. Ciprofloxacin may be a useful alternative drug in the treatment of prostatitis.     

Exposure to quinolones is associated with carbapenem resistance among colistin-susceptible Acinetobacter baumannii blood isolates

In this study, we explored risk factors associated with bacteraemia caused by colistin-susceptible/carbapenem-resistant (Co(S)/Ca(R)) Acinetobacter baumannii. A retrospective cohort study of hospitalised patients with A. baumannii bacteraemia was performed at a tertiary care hospital over a 44-month period. Thirty-nine patients with bacteraemia due to A. baumannii (35 Intensive Care Unit and 4 ward patients) were included in the analysis. Twenty-five patients (64%) had bacteraemia due to Co(S)/Ca(R)A. baumannii and 14 patients (36%) had bacteraemia due to colistin-susceptible/carbapenem-susceptible A. baumannii. Mortality was 56% (14/25) and 35.7% (5/14) for patients in the two groups, respectively (P=0.22). Bivariate analysis showed that prior exposure to fluoroquinolones (P=0.01) and antipseudomonal penicillins (P=0.004) as well as a higher number of antibiotics in use on the day of bacteraemia (P=0.02) were associated with isolation of a Co(S)/Ca(R) strain among patients with A. baumannii bacteraemia. Multivariate analysis using a backward logistic regression model showed that only exposure to fluoroquinolones was associated with development of Co(S)/Ca(R)A. baumannii bacteraemia (odds ratio=11.6; 95% confidence interval 2.4-55.9; P=0.02). The appearance of Co(S)/Ca(R)A. baumannii infections represents a major threat to critically ill hospitalised patients. Exposure to fluoroquinolones is an independent risk factor for development of Co(S)/Ca(R)A. baumannii bacteraemia.