Among Gram-negative bacteria, resistance to -lactams is mediated primarily by -lactamases (EC 3.2.6.5), periplasmic enzymes that inactivate -lactam antibiotics. Substitutions at critical amino acid positions in the class A -lactamase families result in enzymes that can hydrolyze extended-spectrum cephalosporins, thus demonstrating an "extended-spectrum" -lactamase (ESBL) phenotype. Using SHV ESBLs with substitutions in the ⍀ loop (R164H and R164S) as target enzymes to understand this enhanced biochemical capability and to serve as a basis for novel -lactamase inhibitor development, we determined the spectra of activity and crystal structures of these variants. We also studied the inactivation of the R164H and R164S mutants with tazobactam and SA2-13, a unique -lactamase inhibitor that undergoes a distinctive reaction chemistry in the active site. We noted that the reduced K i values for the R164H and R164S mutants with SA2-13 are comparable to those with tazobactam (submicromolar). The apo enzyme crystal structures of the R164H and R164S SHV variants revealed an ordered ⍀ loop architecture that became disordered when SA2-13 was bound. Important structural alterations that result from the binding of SA2-13 explain the enhanced susceptibility of these ESBL enzymes to this inhibitor and highlight ligand-dependent ⍀ loop flexibility as a mechanism for accommodating and hydrolyzing -lactam substrates.The most common -lactamases found in Escherichia coli and Klebsiella pneumoniae are the class A enzymes TEM, SHV, and CTX-M (4, 23). Point mutations in the bla TEM and bla SHV genes result in single-amino-acid substitutions that broaden the substrate spectrum of the common TEM and SHV family enzymes to include extended-spectrum cephalosporin antibiotics like ceftazidime or cefotaxime (9). These altered -lactamases are referred to as "extended-spectrum" -lactamases (ESBLs), and this property is referred to as the "ESBL phenotype" (23). The amino acid substitutions responsible for this phenotype in both TEM and SHV enzymes are located in three areas of the class A -lactamase, the ⍀ loop (Ambler residues 164 to 179), the B3 -strand, and residue 104 (2).The ⍀ loop borders the active site on one side and includes the catalytic residue Glu166, which, in addition to aiding in acylation, primes a water molecule needed in the regeneration of the enzyme via the deacylation of the enzyme-substrate complex at Ser70 (2, 16). In wild-type (wt) TEM and SHV, two salt bridges, between residues Arg164 and Asp179 and between residues Arg164 and Glu171, stabilize the loop in place, thereby ensuring the presence of the catalytic Glu166 in the active site. Naturally occurring variants with single-amino-acid changes disrupting the salt bridge at residues 164 to 179, including D179N (SHV-8) in the SHV family and R164H (TEM-29) and R164S (TEM-12) in the closely related TEM -lactamases, have been isolated in the clinic and were shown to have ESBL phenotypes (18,24). Such ESBL activity is hypothesized to result in the increased flexi...