Antimicrobial resistance (AMR) is a major global concern, especially in India where the burden of infectious diseases is high and health care spending is low. Here we quantified total coliform, faecal coliforms (FC), carbapenem-resistant enteric bacteria (CRE), bla_NDM-1, and three integron genes in samples collected from wastewater effluent of 12 hospitals, 12 sewage treatment plants (STPs), 20 sewer drains, and five locations along the Yamuna River in New Delhi over two seasons. Significant correlations were found between FC levels, CRE (r = 0.903, p = 0.004, n = 49) and bla_NDM-1 (r = 0.787, p = 0.003, n = 49) concentrations across all samples. Concentrations of coliforms, CRE, bla_NDM-1, int1, and int3 were highest in hospital effluents compared to other locations in both seasons. Although absolute concentration data indicate greater abundances of CRE and bla_NDM-1 in the winter, normalised data indicates greater carriage of bla_NDM-1 per cell in summer samples. In general, observed CRE levels were highest in surface water downstream of areas with higher population densities. Among CRE isolates (n = 4077), 82%, 75%, 71% and 43% of the strains from hospitals, sewer drains, river samples, and STPs, respectively, contained bla_NDM-1, implying STPs have relatively fewer bla_NDM-1 positive CRE in their effluents. The most common CRE isolates in the drains were Pseudomonas putida (39%) followed by Acinetobacter baumanni (20%) and Pseudomonas montelli (19%). The present scenario in New Delhi highlights the urgent need for increased coverage of appropriate waste treatment facilities across the city to reduce CRE exposures from polluted surface waters.

抗菌素耐药性（AMR）是全球主要关注的问题，尤其是在印度，那里的传染病负担高，医疗保健支出低。在这里，我们对从12家医院，12个污水处理厂（STP），20个下水道的废水中采集的样品中的总大肠菌群，粪便大肠菌群（FC），耐碳青霉烯的肠细菌（CRE），bla _{NDM - 1}和三个整合子基因进行了定量分析在两个季节内，沿新德里的亚穆纳河沿岸的五个排水渠。发现FC水平，CRE（r  = 0.903，p  = 0.004，n  = 49）和bla _NDM-1（r  = 0.787，p  = 0.003，n  = 49）在所有样品中的浓度。与这两个季节的其他地点相比，医院污水中大肠菌群，CRE，bla _NDM-1，int1和int3的浓度最高。尽管绝对浓度数据表明冬季CRE和bla _NDM-1的丰度更高，但归一化数据表明夏季样品中每个细胞的bla _NDM-1携带量更高。通常，在人口密度较高的地区的下游地表水中观察到的CRE水平最高。在CRE分离株中（n = 4077），分别来自医院，下水道，河流样本和STP的菌株中有bla _NDM-1占82％，75％，71％和43％，这表明STP的bla _NDM-1阳性CRE相对较少。他们的废水。排水管中最常见的CRE分离株是恶臭假单胞菌（39％），其次是鲍曼不动杆菌（20％）和蒙特雷假单胞菌（19％）。新德里的当前情况突显了迫切需要在全市范围内增加适当的废物处理设施的覆盖面，以减少受污染的地表水中的CRE暴露。