First cases of gonorrhea resistant to different classes of antibiotics identified in US


Public health officials say they have found two cases of gonorrhea that appear to be less susceptible to any type of antibiotic available to treat them. It is the first time strains of gonorrhea resistant to antibiotics have been identified in the United States.

Increased sexual activity during the pandemic, coupled with fewer people undergoing routine health screenings, has fueled the spread of sexually transmitted diseases around the world.

Those infections, including gonorrhea, are becoming increasingly resistant to the antibiotics available to treat them, a problem that poses a serious threat to public health.

Worldwide, approximately 700,000 people die each year from antibiotic-resistant infections. That number is expected to rise to 10 million deaths per year by 2050 if measures are not taken to stop the spread of drug-resistant organisms.

Experts say it was never a question of when this highly resistant strain of gonorrhea would reach the US, but when.

“The concern is that this particular species is circulating around the world, so it was only a matter of time before it reached the US,” says Dr. Jeffrey Klausner, a clinical professor of public health at Keck University in Southern California. medical school in Los Angeles.

“It reminds us that gonorrhea is becoming increasingly resistant and difficult to treat. We have no new antibiotics. We haven’t had any new antibiotics to treat gonorrhea for years, and we really need a different treatment strategy,” said Klausner, who is part of the CDC’s workgroup on gonorrhea treatment.

Gonorrhea is sexually transmitted and one of the most commonly diagnosed infections in the US. It is caused by the bacteria Nisseria gonorrhoeae, which can infect the mucous membranes in the genitals, rectum, throat and eyes.

People can become infected without having any symptoms. Left untreated, the infection can cause pelvic pain and infertility in women and blindness in newborns.

In addition to reduced susceptibility to ceftriaxone, the Massachusetts-identified strains of gonorrhea also showed reduced susceptibility to cefixime and azithromycin; the strains were resistant to ciprofloxacin, penicillin and tetracycline, according to a clinical alert sent to doctors by the Massachusetts Department of Public Health.

The MDPH says it has not yet found a connection between the two cases.

In 2021, the US Centers for Disease Control and Prevention recommended giving a double dose of the antibiotic ceftriaxone in an attempt to overcome the bacteria’s resistance to this antibiotic, and that seems to have worked in these cases, but that antibiotic is the last rule of defense against this infection, and experts say a new approach is needed.

Klausner hopes to gain FDA approval for a test that would tailor antibiotic treatment to the genetic susceptibility of the specific gonorrhea strain infecting a person. This is called resistance-controlled treatment, and Klausner says it works for HIV, TB, and some other hospital-acquired infections, but it’s never really been tried for gonorrhea.

This form of gonorrhea has previously been observed in Asia-Pacific countries and in the UK, but not in the US. A genetic marker common to these two Massachusetts residents was also previously seen in a Nevada case, though that strain remained sensitive to at least one class of antibiotics.

The first symptoms of gonorrhea are often painful urination, abdominal or pelvic pain, increased vaginal discharge, or bleeding between periods, but according to the CDC, many infections are asymptomatic, making routine screenings important for catching the infection.

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