Evolution and dissemination of beta-lactamases accelerated by generations of beta-lactam antibiotics.

beta-Lactamases are the principal mechanism of bacterial resistance to beta-lactam antibiotics. In recent years the number and variety of new beta-lactamases detected has risen at an alarming rate, apparently in response to the clinical use of novel classes of beta-lactam antibiotics. This paper reviews the structure and evolution of beta-lactamases in an attempt to understand the pressures that have contributed to their emergence.