Molecular Epidemiology of Clinical Isolates from Central Panama.

represents one of the most common causes of community-onset and nosocomial infections. Strains carrying extended spectrum β-lactamases (ESBL) are a serious public health problem. In Central America we have not found studies reporting the molecular epidemiology of strains implicated in local infections, so we conducted this study to fill that gap. We report on an epidemiological study in two reference hospitals from central Panama, identifying the susceptibility profile, associated risk factors, and molecular typing of strains isolated between November 2018 and November 2019 using Pasteur's Multilocus Sequence Typing (MLST) scheme. A total of 30 isolates with antimicrobial resistance were analyzed, 70% of which came from inpatients and 30% from outpatients ( < 0.001). Two-thirds of the samples came from urine cultures. Forty-three percent of the strains were ESBL producers and 77% were resistant to ciprofloxacin. We identified 10 different sequence types (STs) with 30% of the ESBL strains identified as ST43, which corresponds to ST131 of the Achtman MLST scheme-the pandemic clone. Thirty-eight percent of the strains with the ESBL phenotype carried CTX-M-15. To the best of our knowledge, this is the first report confirming the presence of the pandemic clone ST43/ST131 harboring CTX-M-15 in Central American inpatients and outpatients. This strain is an important antimicrobial-resistant organism of public health concern, with potential challenges to treat infections in Panama and, perhaps, the rest of Central America.