The sporadic emergence of Klebsiella pneumoniae strains resistant to
cefepime and cefpirome was observed in Greek hospitals during 1996.
Examination of six epidemiologically distinct strains and clones
selected in vitro provided indications that resistance is due to the
cooperation of decreased outer membrane permeability and hydrolysis of
the cephalosporins by SHV-5 beta-lactamase, which was produced in large
amounts
