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These data demonstrate significant increases in the application of some laparoscopic surgical techniques, particularly for morbid obesity. Future health-care planning will need to consider the impact of these changes.

Aims: To evaluate the Sentinel automated blood culture system and to compare its performance with that of Bactec. Methods: The Sentinel blood culture system was evaluated in three centres. The performance ofthe system was assessed in comparison with the routine blood culture method used in these centres, the Bactec system. Results: Blood culture sets (n = 2180) consisting of Sentinel aerobic and anaerobic, and Bactec aerobic and anaerobic bottles yielded 218 (10%) clinicaily important isolates. One hundred and fifty five (7 1%) of the isolates were detected by both systems; 35 (16%) were detected by Sentinel only; and 28 (13%) by Bactec only. For the duration of the evaluation, the Sentinel system was deliberately configured so that it was impossible to detect positive results during the first 12 hours. The times to positivity after the first 12 hours were similar. Data gathered during and subsequent to the evaluation have been used by the manufacaturer to refine the algorithm so that positive results can be detected at a minimum of 2 25 hours. Conclusions: After a period of familiarisation the Sentinel system was considered easy to use. Sentinel is a useful addition to the methods available for the detection of bacteria in blood cultures.

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