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IMP-26 was a rare IMP variant with more carbapenem-hydrolyzing activities, which was increasingly reported now in China. This study characterized a transferable multidrug resistance plasmid harboring  bla  IMP-26  from one  Enterobacter cloacae  bloodstream isolate in Shanghai and investigated the genetic environment of resistance genes. The isolate was subjected to antimicrobial susceptibility testing and multilocus sequence typing using broth microdilution method, Etest and PCR. The plasmid was analyzed through conjugation experiments, S1-nuclease pulsed-field gel electrophoresis and hybridization. Whole genome sequencing and sequence analysis was conducted for further investigation of the plasmid.  E. cloacae  RJ702, belonging to ST528 and carrying  bla  IMP-26 ,  bla  DHA-1 ,  qnrB 4 and  fosA5 , was resistant to almost all β-lactams, but susceptible to quinolones and tigecycline. The transconjugant inherited the multidrug resistance. The resistance genes were located on a 329,420-bp IncHI2 conjugative plasmid pIMP26 (ST1 subtype), which contained  trhK/trhV ,  tra ,  parA  and  stbA  family operon. The  bla  IMP-26  was arranged following  intI1 . The  bla  DHA-1  and  qnrB4  cluster was the downstream of IS CR1 , same as that in p505108-MDR. The  fosA5  cassette was mediated by IS 4 . This was the first report on complete nucleotide of a  bla  IMP-26 -carrying plasmid in  E. cloacae  in China. Plasmid pIMP26 hosted high phylogenetic mosaicism, transferability and plasticity.

A Multidrug Resistance Plasmid pIMP26, Carrying blaIMP-26, fosA5, blaDHA-1, and qnrB4 in Enterobacter cloacae