Emergence of hypermucoviscous colistin-resistant high-risk convergent <i>Klebsiella pneumoniae</i> ST-2096 clone from Pakistan.

<i>Klebsiella pneumoniae</i> convergent clones are considered a threat to healthcare settings. Here we report a comprehensive genomic profiling of an emerging colistin-resistant <i>K. pneumoniae</i> ST-2096 convergent clone from Pakistan. <b>Methods:</b> Whole-genome sequencing was performed and raw reads were assembled antimicrobial resistance and virulence genes were predicted using various online tools. <b>Results &amp; conclusion:</b> The phenotypically multidrug-resistant (MDR) and hypermucoviscous (hv) colistin-resistant <i>K. pneumoniae</i> (hvCRKP-10718), which, intriguingly, possessed a wide range of antimicrobial resistance (<i>bla</i>_TEM-1A, <i>bla</i>_OXA-1, <i>bla</i>_OXA-232, <i>bla</i>_CTX-M-15, <i>bla</i>_SHV-106, <i>oqxA</i>, <i>oqxB</i>, <i>aac(6')-Ib-cr</i>, <i>aadA2</i>, <i>aac(6')-Ib-cr</i>, <i>armA</i>, <i>tetD</i>, <i>mphE</i>, <i>msrE</i>, <i>fosA</i>, <i>dfrA1</i>, <i>dfrA12</i>, <i>dfrA14</i>, <i>catB3</i>, <i>sul1</i>) and virulence determinants (<i>RmpA/RmpA2</i>, yersiniabactin [<i>ybt</i>], aerobactin [<i>iuc/iut</i>], enterobactin). Furthermore, the acquisition of various mobile genetic elements (MDR/virulent plasmids, type II integron gene cassette, insertional sequences, transposases) and associated hv capsular type made this MDR/hv isolate a convergent clone belonging to a high-risk lineage (ST-2096). Based on core-genome multilocus sequence typing and single-nucleotide polymorphism analysis, this isolate showed ≥99% nucleotide identity with MDR <i>K. pneumoniae</i> isolates from India, depicting its evolutionary background. This study provides a comprehensive genomic profiling of this high-risk convergent <i>K. pneumoniae</i> ST-2096 clone from Pakistan. Comparative genomics of MDR/hv colistin-resistant <i>K. pneumoniae</i> isolates with other MDR convergent strains from the Indian subcontinent indicated the emergence of this evolving superbug.