Objective: To investigate the clinical and angiographic characteristics of coronary artery ectasia (CAE) and its relation with the inflammatory marker, HsCRP.

BackgroundStaphylococcus aureus (S. aureus) is a virulent pathogen that is currently the most common cause of infections in hospitalized patients. Health care workers (HCWs) play a significant role in the epidemiology of Methicillin Resistant S. aureus (MRSA) infection. HCWs act as a vector for transmission of MRSA as they work at the interface between hospital and the community. Transmission of MRSA in health care environment is usually by contact between patients through hands, cloths or equipment of HCWs. ObjectivesTo determine the percentage of HCW's having MRSA carriage at a tertiary care hospital in Rawalpindi Pakistan. Materials and methodsNasal swabs from anterior nares of HCWs were cultured on Blood agar and Macconkey Agar and Mannitol Salt Agar (MSA) and incubated at 35°C for 24-48 hours. S. aureus growth was confirmed by colony morphology, gram staining and biochemical tests. MRSA were identified by observing zone of inhibition around Cefoxitin disc on Mueller Hinton Agar (MHA) according to CLSI guidelines. ResultsThe frequency of nasal carriage of MRSA was 6.5%. High nasal carriage was seen in ITC among the nursing staff. ConclusionHigh frequency of MRSA nasal carriage in ITC staff reflects poor hand hygiene and urgent need for infection control measures.

Salmonella enterica serovar Typhi (S. Typhi) is one of the typhoidal Salmonellae that causes typhoid fever. We report the first case of an XDR S. Typhi in a suspected case of Endocarditis with Aortic Valve Replacement and deranged INR. The identification was carried out by an automated system. The antibiogram was performed according to CLSI recommendations. The XDR S. Typhi isolates were found resistant to Azithromycin. Although XDR S. Typhi has been reported in our country and elsewhere, however, till to date no complete resistant isolate of S. Typhi to Azithromycin has been reported in Pakistan. The patient had a smooth recovery on intravenous meropenem. The case highlights the importance of the acquisition of resistance to the last line antibiotics in S. Typhi in our country and is of concern to infectious disease specialists to ensure infection control to avoid its spread.