PCR for VIM, IMP, KPC and NDM-1 genes (self designed, Table 1) was performed for confirmation. Sequence analysis All isolates found to carry ESBL/ampC or carbapenemase gene were further confirmed by sequencing. Sequencing was performed as per manufacturer’s guidelines in 3130×l genetic analyser (Applied Biosystems, Foster city, California). Further the nucleotide and deduced amino acid sequences were analyzed and compared with sequences available in Gene

bank at the National centre of Biotechnology Information (NCBI) web site (http://​www.​ncbi.​nlm.​nih.​gov/​). Results Gut colonization c-Met inhibitor pattern of Enterobacteriaceae and distribution of ESBL and AmpC β -lactamases in Selleck GSK2245840 healthy low birth weight Neonates (1–60 days) On D1, 65.3% of babies were colonized with Enterobacteriaceae with no significant increase on D60. The predominant flora was E. coli on day 1, 21 and 60 followed by Klebsiella pneumoniae (Table 2). Table 2 Distribution of Enterobacteriaceae and associated ESBL and AmpC β- lactamases in Neonates   Total Day 1 Day 21 Day 60 (N = 75) (N = 75) (N = 75) No. (%) No. (%) No. (%) Babies colonized with a least one species   49 (65.3) 48 (64) 53 (70.6) No of babies colonized with at least one ESBL producing isolate   7/49 (14.3) 13/48 (27.1) 22/53 (41.5)* Total Enterobacteriaceae

strains # 267 79 88 100 E.coli 219 69 (87.3) 67 (76.1) 83 (83) Klebsiella pneumoniae 27 3 (3.8) 13 (14.8) 11 (11) Enterobacter sp 14 2 (2.5) 7 (8) 5 (5) Citrobacter Methane monooxygenase sp 5 4 (5.1) 0 1 (1) Salmonella. Typhi 2 1 (1.3) 1(1.1) AZD2171 mouse 0 Total ESBL 55 (20.6) 7 (8.9) 17 (19.3) 31 (31)** Total AmpC (N = 39) 53 (19.9) 16 (20.3) 12 (13.6) 25 (25)*** Co-Production of ESBL and AmpC 30 (11.2) 5 (6.3) 9 (10.2) 16 (16)**** Note: Data represents

Enterobacteriaceae isolates from gut of 75 healthy Low birth weight (LBW) neonates on Day 1, 21, 60 of birth. All Figures in parentheses represent percentages. # Some babies had more than one morphologically and biochemically distinct isolates. *p value 0.005 **p value 0.001 ***p value 0.2 ****p value 0.05 when compared to Day 1. Overall ESBL and AmpC production was 20.6% and 19.9% respectively. The total isolates positive for either AmpC and or ESBL were 29.2% (78/267). The predominant phenotypes were co-producers (30/267, 11.23%), followed by only ESBL (25/267, 9.4%) and AmpC (23/267, 8.6%) isolates. Both no. of babies colonized with at least one ESBL producing isolate and ESBL rate amongst Enterobacteriaceae increased three fold (p value 0.005 and 0.001 respectively) from day 1 to day 60, irrespective of associated AmpC production (Table 2). Characteristics of ESBL and AmpC β – lactamases in Enterobacteriaceae isolates from 27 randomly selected neonates The three stool samples from 27 neonates generated 88 gram negative bacilli which included E.