Outbreak of Efficiently Transferred Carbapenem-Resistant -Producing Gram-Negative Bacilli Isolated from Neonatal Intensive Care Unit of an Indian Hospital.

The emergence of particularly in Gram-negative bacteria is a burden on the health care system in developing countries. Hence, this study was initiated to screen New Delhi Metallo-β-lactamase (NDM)-producing Gram-negative bacterial strains from neonatal intensive care unit (NICU) of an Indian Hospital. A total of 18 -producing isolates were detected in the present study. Out of 18 variant isolates, 6 were , 4 , 2 , 1 , 1 , 3 and 1 from NICU, showing resistance against all antibiotics, except colistin and polymixin. The transferability of resistance determinants was tested by conjugation. Transfer of -producing strains was successful in all 18 strains. In the case of transconjugants, the minimum inhibitory concentration values were found to decrease. The -producing isolates contained detectable plasmids of size 66, 38, and 6 kb. Plasmi/d-based replicon typing revealed the incompatibility types Inc (A/C, FIIA, FIC, K, F, W, FIA, P, X, FIB, B/O) in -carrying isolates. This study revealed the outbreak of multiple variants of (13 NDM-1, 4 NDM-5, and 1 NDM-7). Moreover, other resistance markers, viz. , , , and coassociated with were also found. In this study, we reported NDM-producing as a first report to the best of our knowledge. This study is an attempt to reveal the dissemination of isolated from neonates in NICU and their efficient transferability among Gram-negative bacilli through horizontal gene transfer.