Introduction: Endocarditis is a rare disorder which is associated with significant morbidity & mortality world over especially in the developing countries. The etiology of disease has gradually shifted from Rheumatic heart disease to prosthetic & device associated endocarditis in the developed world. Very little is known about its etiology in Pakistan.Objective: To find out the frequency of disease and organisms leading to endocarditis in children admitted in Rawalpindi Institute of Cardiology.Methods: A retrospective cross sectional study was carried out in indoor pediatric patients at Rawalpindi Institute of Cardiology in Rawalpindi from Jan 1 st till Oct 15 th 2017. Out of 120 clinical suspected patients of endocarditis, only fifty patients fulfilled Modified Dukes Criteria for the diagnosis of endocarditis. Three sets of blood cultures were collected from the patients having fever before the start of antibiotics. Samples were incubated in Bact Alert 3D automated blood culture system (Biomereux France). All indicator positives were subcultured using standard microbiological methods. The blood cultures were followed daily & negative cultures were reported after 7 days of incubation. Echocardiographic findings were taken from patient's clinical record. All the collected quantitative data were analyzed by SPSS 19.0.Results: Endocarditis was diagnosed in 50/120 (41.6%) patients. There were 35 (70%) males & 15 (30%) females. The mean age of patients was 5.5(±1.7) years. The most common presenting complaints were fever, shortness of breath, chest discomfort & cyanotic spells. The common underlying disease associated with endocarditis was Congenital Heart Disease (CHD) (52%) followed by Rheumatic Heart Disease (RHD) (32%). Blood cultures were positive in 16 (32%) patients while in 34 (68%) patients, blood cultures were negative. Coagulase negative Staphylococcus was the most frequently isolated organism 5/16 (31.2%) in our studied patients.

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Acinetobacter is an important nosocomial pathogen to cause infections such as pneumonia, bloodstream infections, meningitis, wound and surgical site infections including flesh eating bacterium necrotizing fasciitis and urinary tract Infections. A. baumannii can be spread through direct contact with surfaces, objects and the skin of contaminated persons. Acinetobactter has acquired resistance to most of the antibiotics and can play havoc in hospital environment due to its ability to survive desiccation and in moist environment in the presence of disinfectants. Currently, there are 32 genospecies of Acinetobacter known. Among these, A. baumannii is the most important in the clinical context, since it is the most frequently isolated in nosocomial infections and the one associated with the highest mortality rate. Objective To find out the frequency of A. baumannii causing surgical site infections after cardiac surgery and best antibiotic options for its treatment in patients admitted in Rawalpindi Institute of Cardiology. Materials and Methods A retrospective study was carried out to find out bacterial cultures in admitted patients at Rawalpindi Institute of Cardiology with surgical site infections from July 2017 to August 2018. A total of 405 pus specimens collected from patients with suspected surgical site infections were tested for bacterial culture and antimicrobial susceptibility test. Patient profile was noted from centralized hospital data. Results Out of total 405 specimens 13 were culture positive for A. baumannii (3.2%). Ten isolates were Pan Drug Resistant (PDR). Conclusion A. baumannii infection although infrequent in our set up is mostly pan resistant. Infection control practices & surveillance are important to avoid its spread in hospitalized patients.

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