Background: The increase in infections as a result of multi-drug resistant strains of Escherichia coli is a global health crisis. The emergence of globally disseminated lineages of E. coli carrying ESBL genes has been well characterised. An increase in strains producing carbapenemase enzymes and mobile colistin resistance is now being reported, but there is little data on emerging global lineages of such strains. Methods: Routine screening of patients within an ICU of West China Hospital identified a potential outbreak of E. coli carrying the blaNDM-5 carbapenemase gene. Genome sequencing was performed on the strains isolated. The MLST lineage of the strains was determined and a global collection of genomes of relevant lineages utilised to characterise the emergence of two globally disseminated carbapenemase-producing Enterobacteriaceae (CPE) lineages of E. coli. Findings: Our data describes the presence of E. coli ST167 and ST617 in a potential West China Hospital outbreak, which are globally disseminated CPE lineages of E. coli. Both lineages show extreme levels of MDR gene acquisition ranging across ESBL, CPE, and mobile colistin resistance genes. Our analysis also shows real-time switching of CPE genes in a plasmid and real-time transfer of the plasmid across lineages, as well as recent inter-continental transmission of the ST167 lineage. Interpretation: Our data suggests that dominant lineages of E. coli are emerging as CPE clinical threats, in much the same way as occurred for ESBL lineages of E. coli.