Reduced susceptibility to chlorhexidine disinfectant among New Delhi metallo‑beta‑lactamase‑1 positive Enterobacteriaceae and other multidrug‑resistant organisms: Report from a tertiary care hospital in Karachi, Pakistan.

We analysed susceptibility of multidrug‑resistant organisms (MDROs) including New Delhi metallo‑beta‑lactamase‑1 positive Enterobacteriaceae to chlorhexidine and compared results to their susceptible counterparts. Susceptibilities of chlorhexidine digluconate in a standard (CHX‑S) preparation and two commercial disinfectants containing different CHX concentrations (2% w/v and 4% w/w) were performed. MDROs had narrower range of higher CHX‑S minimum inhibitory concentrations (MICs) as compared to pan‑sensitive organisms. The MIC values for commercial disinfectants products for MDROs were many folds higher (20–600 times), than CHX‑S for in vitro use. Increasing antibiotic resistance among bacterial isolates can be an indirect marker of reduced susceptibility to chlorhexidine in hospital setting.

Dermoid cyst of the caecum.

Dermoid cysts of the caecum are rare and only four cases have been reported in the literature. They are sequestration cysts and are lined by squamous epithelium with skin appendages. Aetiologically these cysts may represent squamous metaplasia of enterogenous cysts or sequestration cysts due to epidermal inclusion at the time of closure of the neural groove.

Molecular biological approaches to the study of vectors in relation to malaria control

To a large extent, control of malaria vectors relies on the elimination of breeding sites and the application of chemical agents. There are increasing problems associated with the use of synthetic insecticides for vector control, including the evolution of resistance, the high cost of developing and registering new insecticides and an awareness of pollution from insecticide residues. These factors have stimulated interest in the application of molecular biology to the study of mosquito vectors of malaria; focussing primarily on two aspects. First, the improvement of existing control measures through the development of simplified DNA probe systems suitable for identification of vectors of malaria. The development of synthetic, non-radioactive DNA probes suitable for identification of species in the Anopheles gambiae complex is described with the aim of defining a simplified methodology wich is suitable for entomologist in the field. The second aspect to be considered is the development of completely novel strategies through the development of completely novel strategies through the genetic manipulation of insect vectors of malaria in order to alter their ability to transmit the disease. The major requirements for producing transgenic mosquitoes are outlined together with the progress wich has been made to date and discussed in relation to the prospects which this type of approach has for the future control of malaria