Stoesser, N.Sheppard, A.E.Peirano, GiseleAnson, L.W.Pankhurst, L.Sebra, R.Phan, H.T.T.Kasarskis, A.Mathers, A.J.Peto, T.E.A.Bradford, P.Motyl, M.R.Walker, A.S.Crook, D.W.Pitout, Johann D.D.2017-08-232017-08-232017-07-19Stoesser, N., Sheppard, A.E., Peirano, G., Anson, L.W., Pankhurst, L., Sebra, R., Phan, H.T.T., Kasarskis, A., Mathers, A.J., Peto, T.E.A., Bradford, P., Motyl, M.R., Walker, A.S., Crook, D.W. & Pitout, J.D. 2017, 'Genomic epidemiology of global Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli', Scientific Reports, vol. 7, art. no. 5917, pp. 1-11.2045-2322 (online)10.1038/s41598-017-06256-2http://hdl.handle.net/2263/61777The dissemination of carbapenem resistance in Escherichia coli has major implications for the management of common infections. blaKPC, encoding a transmissible carbapenemase (KPC), has historically largely been associated with Klebsiella pneumoniae, a predominant plasmid (pKpQIL), and a specific transposable element (Tn4401, ~10 kb). Here we characterize the genetic features of blaKPC emergence in global E. coli, 2008–2013, using both long- and short-read whole-genome sequencing. Amongst 43/45 successfully sequenced blaKPC-E. coli strains, we identified substantial strain diversity (n = 21 sequence types, 18% of annotated genes in the core genome); substantial plasmid diversity (≥9 replicon types); and substantial blaKPC-associated, mobile genetic element (MGE) diversity (50% not within complete Tn4401 elements). We also found evidence of inter-species, regional and international plasmid spread. In several cases blaKPC was found on high copy number, small Col-like plasmids, previously associated with horizontal transmission of resistance genes in the absence of antimicrobial selection pressures. E. coli is a common human pathogen, but also a commensal in multiple environmental and animal reservoirs, and easily transmissible. The association of blaKPC with a range of MGEs previously linked to the successful spread of widely endemic resistance mechanisms (e.g. blaTEM, blaCTX-M) suggests that it may become similarly prevalent.en© 2017 [Author et al] This is an open-access article distributed underthe terms of the Creative Commons Attribution License 4.0.Escherichia coliInfectionsCarbapenemase (KPC)Mobile genetic element (MGE)ResistanceEnterobacteriaceaeEmergencePlasmidsClinical isolateSequence typeArticle