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In some enterobacterial pathogens, but not in Escherichia coli, loss-of-function mutations are a common route to clinically relevant [beta]-lactam antibiotic resistance. We previously constructed an assay system for studying enterobacterial [beta]-lactam resistance mutations using the well-developed genetics of E. coli by integrating enterobacterial ampRC genes into the E. coli chromosome. Like the cells of other enterobacteria, E. coli cells acquire [beta]-lactam resistance by ampD mutation. Here we show that starvation and stress responses provoke ampD [beta]-lactam resistance mutagenesis. When starved on lactose medium, [Lac.sup.-] strains used in mutagenesis studies accumulate ampD [beta]-lactam resistance mutations independent of Lac reversion. DNA double-strand break repair (DSBR) proteins and the SOS and RpoS stress responses are required for this mutagenesis, in agreement with the results obtained for lac reversion in these cells. Surprisingly, the stress-induced ampD mutations require DinB (DNA polymerase IV) and partially require error-prone DNA polymerase V, unlike lac mutagenesis, which requires only DinB. This assay demonstrates that real-world stressors, such as Starvation, can induce clinically relevant resistance mutations. Finally, we used the ampD system to observe the true forward-mutation sequence spectrum of DSBR-associated stress-induced mutagenesis, for which previously only frameshift reversions were studied. We found that base substitutions outnumber frameshift mutations, as seen in other experimental systems showing stress-induced mutagenesis. The important evolutionary implication is that not only loss-of-function mutations but also change-of-function mutations can be generated by this mechanism. doi: 10.1128/JB.00732-09