Gonorrhea Strain Outsmarts Antibiotics

"A highly drug-resistant strain of gonorrhea has been detected in the U.S. for the first time, raising concerns among public-health officials about the scarcity of treatments and a future when gonorrhea could become untreatable.

The Massachusetts Department of Public Health said on Jan. 19 that it had detected two cases of a novel strain of gonorrhea that was more impervious to existing antibiotics than any other strain previously recorded in the U.S.

"This is a warning and an opportunity," said Kathleen Roosevelt, who leads the state agency's sexually transmitted infections division. "We know gonorrhea is increasing, drug resistance is increasing and antibiotics are starting to run out."

Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, is primarily spread through sexual contact or from a mother to an infant during childbirth, according to the Centers for Disease Control and Prevention. Gonorrhea is the second-most commonly reported bacterial sexually transmitted infection in the U.S., after chlamydia, and incidence of the disease has risen sharply in recent years, the CDC said.

Almost 700,000 cases of gonorrhea were confirmed in the U.S. in 2021, a 130% increase since 2009, the CDC said. Early in the Covid-19 pandemic, reduced screening and less access to care could have contributed to longer, untreated infections and more spread, the CDC said.

Gonorrhea continues to evolve, increasing resistance to available antibiotics, infectious-disease experts said. In 2020, about half of all gonorrhea infections in the U.S. were estimated to be resistant to at least one antibiotic, the CDC said.

"There's nothing we've thrown at gonorrhea that it hasn't developed resistance to," said Supriya Mehta, an epidemiologist at University of Illinois Chicago.

Bacterial and fungal resistance to antibiotics is a global public-health concern. The World Health Organization has said multidrug-resistant pathogens, or "superbugs," could kill more than 10 million people annually by 2050 if new antibiotics aren't developed.

The WHO and CDC said gonorrhea is among the drug-resistant bacteria of greatest public-health concern. Globally, the WHO estimates there were at least 82 million new cases of gonorrhea among people ages 15 to 49 in 2020.

Gonorrhea can cause long-term complications including pelvic inflammation, infertility and ectopic pregnancies in women, scrotal pain and swelling in men, and blindness in newborns. Untreated gonorrhea increases the risk of getting or transmitting HIV.

The CDC recommends just one drug for the treatment of gonorrhea, the antibiotic ceftriaxone. If a patient is allergic to the drug, a combination of gentamicin and azithromycin is recommended. Cefixime is recommended if ceftriaxone isn't available. The superbug in Massachusetts had a reduced susceptibility to ceftriaxone, cefixime and azithromycin, and resistance to other antibiotics, officials said." [1]

1. U.S. News: Gonorrhea Strain Outsmarts Antibiotics
Mosbergen, Dominique.  Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 30 Jan 2023: A.5.