Complete genome sequence of pandrug-resistant Klebsiella pneumoniae MS6671

Using Single Molecule Real Time (SMRT) sequencing we determined the complete genome of a pandrug-resistant Klebsiella pneumoniae isolate, representing the first complete genome sequence of a Carbapenem resistant Enterobacteriaceae (CRE) resistant to all commercially available antibiotics. The precise location of acquired antibiotic resistance elements, including mobile elements carrying genes for the OXA-181 carbapenemase, were defined. Intriguingly, we identified three chromosomal copies of an identical ISEcp1-blaOXA-181 mobile element, one of which has disrupted the mgrB regulatory gene, accounting for resistance to colistin. Our findings reveal the critical role of mobile resistance elements in accelerating the emergence of resistance to other last resort antibiotics.