“…Furthermore, this plasmid confers little resistance to CER and the MIC values of this antibiotic were unchanged when the plasmid was present (2). In contrast, the R plasmids in our study affected the permeability of recipients for cephalosporins but not for penicillins (9), and conferred resistance to cephalosporins including CER. Although it is still uncertain whether ,B-lactamase itself may function as a mediator of permeability regulation or not, it is likely to cause synergistical elevation of the level of resistance to CER in association with another factor conceivably contributing to alteration of bacterial cell membranes.…”