{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T16:07:54Z","timestamp":1759939674861,"version":"3.40.2"},"reference-count":36,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2024,9,2]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p><jats:italic>Chlamydia trachomatis<\/jats:italic>is classified into 15 major genotypes, A to L3, based on the diversity of<jats:italic>ompA<\/jats:italic>gene. Here, we evaluated and characterised the distribution and diversity of<jats:italic>ompA<\/jats:italic>-genotypes over 32 years (1990\u20132021) in Portugal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The collection of the Portuguese National Reference Laboratory for Sexually Transmitted Infections includes 5824<jats:italic>C<\/jats:italic>.<jats:italic>trachomatis<\/jats:italic>-positive samples that were successfully<jats:italic>ompA<\/jats:italic>-genotyped between 1990 and 2021. An in-depth analysis of<jats:italic>ompA<\/jats:italic>-genotypes distribution across the years, as well as by biological sex, age and anatomical site of infection was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>ompA<\/jats:italic>-genotype E was consistently the most frequently detected across the years, with a median frequency of 34.6%, followed by D\/Da (17.6%), F (14.3%) and G (10.7%). The prevalence of lymphogranuloma venereum (LGV) genotypes (mostly L2, 62.0%, followed by L2b, 32.1%) increased since 2016, reaching the highest value in 2019 (20.9%). LGV, G and Da genotypes were associated with biological sex, specifically with being male, and were the most frequent among anorectal specimens (37.7%, 19.4% and 17.7%, respectively). Notably, LGV<jats:italic>ompA<\/jats:italic>-genotypes represented 38.9% of the male anorectal specimens since 2016, and were also detected among oropharynx and urogenital samples.<jats:italic>ompA<\/jats:italic>-genotype E was the most frequently detected at the oropharynx (28.6%) and urogenital (33.9%) sites during the study period, followed by D\/Da (17.4%) and F (16.0%) in the urogenital specimens, and by G (26.1%) and D\/Da (25.7%) in oropharynx specimens. Our data also highlight the emergence of the recombinant L2b\/D-Da strain since 2017 (representing between 2.0% and 15.5% of LGV cases<jats:italic>per<\/jats:italic>year) and the non-negligible detection of<jats:italic>ompA<\/jats:italic>-genotype B in urogenital and anorectal specimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides a comprehensive landscape of<jats:italic>C. trachomatis<\/jats:italic>molecular surveillance in Portugal, highlighting the continued relevance of<jats:italic>ompA<\/jats:italic>-genotyping as a complement to rapid LGV-specific detection tests. It also contributes to a deeper understanding of<jats:italic>C. trachomatis<\/jats:italic>epidemiology, diversity and pathogenicity.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2024-056166","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T05:11:34Z","timestamp":1726117894000},"page":"73-80","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Distribution of<i>Chlamydia trachomatis ompA<\/i>-genotypes over three decades in Portugal"],"prefix":"10.1136","volume":"101","author":[{"given":"Zohra","family":"Lodhia","sequence":"first","affiliation":[]},{"given":"Dora","family":"Cordeiro","sequence":"additional","affiliation":[]},{"given":"Cristina","family":"Correia","sequence":"additional","affiliation":[]},{"given":"In\u00eas","family":"Jo\u00e3o","sequence":"additional","affiliation":[]},{"given":"Teresa","family":"Carreira","sequence":"additional","affiliation":[]},{"given":"Lu\u00eds","family":"Vieira","sequence":"additional","affiliation":[]},{"given":"Alexandra","family":"Nunes","sequence":"additional","affiliation":[]},{"given":"Rita","family":"Ferreira","sequence":"additional","affiliation":[]},{"given":"Sandra","family":"Sch\u00e4fer","sequence":"additional","affiliation":[]},{"given":"Elzara","family":"Aliyeva","sequence":"additional","affiliation":[]},{"given":"Clara","family":"Portugal","sequence":"additional","affiliation":[]},{"given":"Isabel","family":"Monge","sequence":"additional","affiliation":[]},{"given":"Maria Ana","family":"Pessanha","sequence":"additional","affiliation":[]},{"given":"Cristina","family":"Toscano","sequence":"additional","affiliation":[]},{"given":"Rita","family":"C\u00f4rte-Real","sequence":"additional","affiliation":[]},{"given":"Mar\u00edlia","family":"Antunes","sequence":"additional","affiliation":[]},{"given":"Joao Paulo","family":"Gomes","sequence":"additional","affiliation":[]},{"given":"V\u00edtor","family":"Borges","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8604-8800","authenticated-orcid":false,"given":"Maria","family":"Jos\u00e9 Borrego","sequence":"additional","affiliation":[]}],"member":"239","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"2025032404400821000_101.2.73.1","unstructured":"World Health Organization . 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