TEM-154, identified in Portugal in 2004, associated the substitutions observed in the extended-spectrum -lactamase (ESBL) TEM-12 and in the inhibitor-resistant penicillinase (IRT) TEM-33. This enzyme exhibited hydrolytic activity against ceftazidime and a low level of resistance to clavulanic acid. Surprisingly, the substitution Met69Leu enhanced the catalytic efficiency of oxyimino -lactams conferred by the substitution Arg164Ser. Its discovery confirms the dissemination of the complex mutant group of TEM enzymes in European countries.TEM-type -lactamases are the most prevalent mechanism of resistance to -lactam antibiotics in Enterobacteriaceae. Among these -lactamases, extended spectrum -lactamases (ESBL) and inhibitor-resistant penicillinases (IRT) have emerged from the parental penicillinases TEM-1 and TEM-2 (2). Since the 1990s, another subgroup of enzymes that combine the substitutions observed in the ESBL and in the IRT appeared; its members were designated complex mutant TEM (CMT) (21). Nine different CMT, mainly in E. coli strains, have been described: TEM-50, TEM-68, TEM-89, TEM-121, TEM-109, TEM-125, TEM-151, TEM-152, and TEM-158, most of which have been identified in France (7,14,(16)(17)(18)(19)(20)(21).In 2004, during a 2-year study of ESBL-producing Enterobacteriaceae from different Portuguese clinical settings (12), Machado et al. identified a novel TEM enzyme that associated the Arg164Ser substitution observed in the ESBL TEM-12 (4) with the Met69Leu substitution observed in TEM-33 (IRT-5) (3). This -lactamase, designated TEM-154, was produced by an Escherichia coli strain, H258, which is resistant to penicillins (alone or associated with clavulanic acid), ceftazidime, all tested aminoglycosides except amikacin, all tested quinolones, sulfamethoxazole, tetracycline, and chloramphenicol.In this study, we characterized the genetic support and the enzymatic activity of TEM-154. E. coli H258 produces only one -lactamase, which has a pI of 5.3. The French double-disk synergy test and CLSI MIC testing confirmed the production of an ESBL by this strain (5, 6). The TEM-154-harboring plasmid did not transfer in mating experiments (19). However, an E. coli DH5␣ transformant harboring the parental phenotype of resistance to -lactams was obtained throughout electroporation of plasmid DNA. Plasmid DNAs were extracted from the clinical strain and transformant by the method of Kado and Liu (8). Plasmid size was determined by comparison with those of plasmids Rsa (39 kb), TP114 (61 kb), pCFF04 (85 kb), and pCFF14 (180 kb), as previously described (15). Plasmid content analysis revealed one plasmid of about 180 kb. TEM-specific PCR and sequencing experiments were performed on the clinical strain H258 and on the transformant as previously described (17) and confirmed the presence of bla . This gene harbored a pattern of silent mutations identical to those of bla TEM-1a and a promoting sequence, P a /P b (11).E. coli DH5␣ clones producing TEM-154, TEM-12, TEM-33, and TEM-1 were obtained using the vector...