Highly carbapenem-resistant harboring in Myanmar.

is a multidrug-resistant, non-glucose-fermenting, gram-negative bacterium with intrinsic resistance to many antimicrobial agents. Between 2016 and 2017, five isolates were obtained from five patients at three hospitals in Myanmar. Minimum inhibitory concentrations (MICs) against various antimicrobial agents were determined using the microdilution method. Whole genome sequencing was performed with the MiSeq and MinION platforms. Resistance genes and their surrounding structures were identified and compared. All five isolates were resistant to amikacin and aztreonam. Among them, one isolate, MyNCGM749, was resistant to imipenem and meropenem with MICs of 256 µg/mL and amikacin with MIC of >512 µg/mL but intermediate to ciprofloxacin with MIC of 2 µg/mL. The isolate carried encoding metallo-β-lactamase, encoding extended-spectrum-β-lactamase, and (encoding intrinsic -β-lactamase present in ), along with five aminoglycoside modification encoding genes including , , , , and on its chromosome. The genetic structure surrounding contained four IS elements identical to those found in carbapenem-resistant isolates in Myanmar. This is the first report of in Myanmar. Although harboring has been reported in a single strain from India, its genomic details have not been previously described. This study indicates that the -containing structure flanked by IS is spreading among gram-negative, non-glucose-fermenting bacteria in Myanmar and neighboring countries.IMPORTANCE species were originally environmental organisms that became opportunistic pathogens with multidrug resistance. is associated with nosocomially acquired infections affecting multiple organ systems, including the respiratory and urinary tracts, and, less commonly, the cardiovascular and central nervous systems. To date, carbapenem-resistant carrying carbapenemase-encoding genes has been reported in several countries, including Greece, India, Italy, Japan, Korea, Libya, and the Netherlands. In this molecular epidemiological study on in Myanmar, we identified the genomic structure surrounding , flanked by IS. This structure may facilitate the spread of non-glucose-fermenting gram-negative bacteria, such as , and species, in Asian countries.