The emergence and spread of carbapenemase genes, colistin resistance genesmcr-1, and tigecycline resistance genetet(X) represent a significant threat to clinical therapy and public health. In this study, we investigated the presence of carbapenemase genes,mcr-1, andtet(X) in 298Escherichia colistrains obtained from a teaching hospital in China. In total, eight (2.68%), six (2.01%), and one (0.34%)E. coliisolates carriedblaNDM,mcr-1, andtet(X4), respectively. TheblaNDMgene was located on IncX3 (n= 4), F2:A-:B- (n= 3), and F2:A1:B1 (n= 1) plasmids, with high similarity to multiple plasmids belonging to the same incompatibility type from Enterobacteriaceae. Six MCR-producing strains containedmcr-1-carrying IncI2 plasmids, organized similarly to othermcr-1-bearing IncI2 plasmids from animals in China. TheblaCTX−M−55/64/132/199gene located within a typical transposition unit (ISEcp1-blaCTX−M-orf477Δ) was inserted neardnaJto generate 5-bp direct repeats in fourmcr-1-positive plasmids. Thetet(X) and another four resistance genes [aadA2, tet(A),floR, and Δlnu(F)] were co-located on an IncX1 plasmid, highly similar to othertet(X4)-carrying IncX1 plasmids fromEscherichiaandKlebsiellaof animal or food origin, except that the conjugative transfer region of IncX1 plasmids was absent in our plasmid. Although a low prevalence ofblaNDM,mcr-1, andtet(X) was observed inE. colifrom patients in this study, their dissemination associated with some successful pandemic plasmids is of great concern. The continued surveillance of these crucial resistance genes in patients should be strengthened.