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Limited data is available on the epidemiology and characteristics of carbapenem-resistant  Enterobacteriaceae  (CRE) and their associated plasmids or virulence determinants from Sri Lanka. Through whole genome sequencing of CREs from the intensive care units of a Sri Lankan teaching hospital, we identified a carbapenemase gene,  bla  OXA–181  in 10 carbapenemase-producing  Klebsiella pneumoniae  isolates (two strains of ST437 and eight strains of ST147) from 379 respiratory specimens.  bla  OXA–181  was carried in three variants of ColE-type plasmids.  K. pneumoniae  strains with  ompK36  variants showed high minimum inhibitory concentrations to carbapenem. Furthermore, genes encoding for extended spectrum β-lactamases (ESBL), plasmid-mediated quinolone resistance (PMQR) determinants ( qnr ,  aac(6′)-Ib-cr , and  oqxAB ) were present in all 10 strains. Amino acid substitution in chromosomal quinolone resistance-determining regions (QRDRs)  gyrA  (Ser83Ile) and  parC  (Ser80Ile) were also observed. All strains had yersiniabactin genes on mobile element ICE kp . Strict infection control practices and judicious use of antibiotics are warranted to prevent further spread of multidrug-resistant  K. pneumoniae .

Characterizing Mobilized Virulence Factors and Multidrug Resistance Genes in Carbapenemase-Producing Klebsiella pneumoniae in a Sri Lankan Hospital