CTX-M-15 is predominant ESBL, TEM-136, TEM-149, SHV-28 and CTX-M-8 was seen in single isolates. In contrast, the ampC was diverse and included DHA (N = 5), CMY-2 (N = 3), CMY-1 (N =2), MOX (N = 2) and FOX (N = 1) (Table 3). Table 3 Molecular Characterization of ESBL & AmpC β-lactamases in Enterobacteriaceae isolated (N = 88) from 27 randomly selected neonates Phenotype No. strains ESBL AMPc     bla-TEM ESBL TEM SHV CTX-M DHA CMY-1 CMY-2 LAT MOX BIL FOX E + A+ 7 7 2* 1** 4# 2   3   2   1 E + A- 10 10     10               E-A+ 5 5       3## 2           E-A- 66 PCR not performed for strains with cefotaxime, ceftazimime zone diameter ≥ 28

and ≥ 23 respectively and phenotypic test negative for ESBL and AmpC16 Note: Sequencing results *Tem 136, Tem 149; **SHV28. E = ESBL, YH25448 A = AmpC, - = Negative, + = Positive. # ESBL and AMPc genes were see more mainly isolated

in E.coli except one Klebsiella pneumoniae having both CTX-M as well as MOX gene. ## One Citrobacter showed the presence of DHA gene. Colonization by carbapenem resistance Enterobacteriaceae in the neonates Total 225 stool samples from 75 enrolled babies were screened for CRE 2-step broth enrichment method incorporating 10 μg meropenem disc. Gram negative colonies were isolated from 22 stool samples, which yielded 29 Enterobacteriaceae isolates that were presumed to be CRE. Phenotypic test for MBL was negative, MIC of 28 suspected CRE ranged from 0.012-0.5 μg/ml, 0.016-0.125 μg/ml and 0.094-0.38 μg/ml for ertapenem, meropenem and imipenem respectively. However, one isolate of Enterobacter aerogenes. was positive for MHT having the MIC of > 32 μg/ml for ertapenem, meropenem and imipenem. Presence

of kpc-2 gene was confirmed by PCR using gene specific primers. Discussion selleck chemicals llc In the present report we have investigated the β-lactam resistance pattern amongst Enterobacteriaceae in gut flora of neonates (1–60 days) by enrolling babies using various selection criteria so as to avoid any possible source of PI3K inhibitor antibiotic selection pressure. Acquisition of resistance through food and water was also ruled out as neonates were exclusively breast fed. Compliance was ensured through household follow up by trained field workers upto D60 of life. The present study shows that majority of the babies were colonized by D1. With the acquisition of mother’s flora the babies are equally likely to get the antibiotic resistance strains. Our data revealed that overall there was nearly 87% (232/267) resistance to the ampicillin by D60 in Enterobacteriaceae. The overall rate of ESBL was 20.6% which may be just a glimpse of bigger picture as in the present study only dominant population was studied. Selective media were not used for screening ESBL gut carriage which would reflect the true representation of ESBL carriage in the community.