The routine phenotypic methods originally identified the NA22 isolates as Klebsiella pneumoniae. Nevertheless, WGS and NCBI annotation have subsequently confirmed that the microorganism is an Escherichia coli. The isolate had been recovered from the bloodstream of a patient and was resistant to many of the most important classes of antibiotics. A total of eight contigs >1,000 bp were generated through sequencing on the Oxford Nanopore platform. Three plasmids, NA22_1, NA22_2, and NA22_3, were identified using PlasmidFinder. Among them, NA22_3 harbored significant resistance genes, including blaNDM-4, blaCTX-M-15, and aac(6’)-Ib-cr, along with the tra operon genes that may facilitate plasmid transfer. Functional annotation was performed against the PATRIC, CARD, and VFDB databases, and 76 resistance and over 200 virulence , as well as over 100 metabolism and transport involved subsystems, were found. The antimicrobial susceptibility tests revealed resistance to β-lactams (including carbapenems), fluoroquinolones, aminoglycosides, and sulfonamides, which were consistent with the genome profile. The complete genome sequence is included in BioProject ID: PRJNA1270365. These results highlight the importance of routine genomic surveillance of multidrug-resistant strains within hospitals. While bioinformatics analyses highlighted the critical importance of routine monitoring of multidrug-resistant strains in the hospital environment, these findings particularly demonstrated the necessity of careful surveillance and personalized treatment strategies to combat the spread of these identified bacteria in clinical settings.