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This book is a work conducted in Kanti Children Hospital, Kathmandu to determine the burden of carbapenem resistant isolates of Enterobacteriaceae producing different types of _-lactamases.It has been observed that, all the classes of carbapenemases have emerged among the Enterobacteriaceae. Since, the profound variation is found in _-lactamases of CRE, to reduce the risk of severe calamity effective detection procedures are mandatory in all the clinical laboratories.