Genotypes and Mutations Associated with Macrolide Resistance of Chlamydia trachomatis in Urine Samples in School-Going, Urban Adolescents 14–19 Years from Panama: A Cross-Sectional Descriptive Study

Chlamydia trachomatis (CT) is a bacterium that causes one of the most common sexually transmitted infections (STIs) worldwide. In Panama, the prevalence of genital Chlamydia trachomatis (CT) among adolescents is 15.8%. However, no data describing circulating CT genotypes or evaluating molecular resistance are available. This study aims to determine the genotypes of genital CT infections and explore the macrolide resistance-associated mutations in this population to contribute to baseline information about CT circulating strains and antimicrobial resistance. Genomic analysis was performed on CT-positive, first-void urine specimens from school-going adolescents (14–19 years) in urban regions in Panama. The ompA gene was used for genotype and phylogenetic analysis, and the rplD, rplV, and 23S rRNA genes were used for molecular resistance analysis. Five genotypes were found: D, 15 (47%); F, 9 (28%); E, 4 (13%); Ia, 2 (6%); and Ja, 2 (6%) genotype Ja. A triple mutation (G52S, R65C, and V77A) was found in the rplV gene, though no mutations of interest were found for the rplD and 23S rRNA genes. The present study indicated CT genotype D had increased circulation within the population; mutations indicative of macrolide resistance were not found. Follow-up studies and implementation of active surveillance are necessary to understand the circulation of CT in Panama.