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Acquisition of a metallo-\u03b2-lactamase gene will invariably mediate broad-spectrum \u03b2-lactam resistance in<jats:italic>P. aeruginosa<\/jats:italic>, but the level of in vitro resistance in<jats:italic>Acinetobacter<\/jats:italic>spp. and Enterobacteriaceae is less dependable. Their clinical significance is further embellished by their ability to hydrolyze all \u03b2-lactams and by the fact that there is currently no clinical inhibitor, nor is there likely to be for the foreseeable future. The genes encoding metallo-\u03b2-lactamases are often procured by class 1 (sometimes class 3) integrons, which, in turn, are embedded in transposons, resulting in a highly transmissible genetic apparatus. Moreover, other gene cassettes within the integrons often confer resistance to aminoglycosides, precluding their use as an alternative treatment. Thus far, the metallo-\u03b2-lactamases encoded on transferable genes include IMP, VIM, SPM, and GIM and have been reported from 28 countries. 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