Gonorrhea Resistant to Antibiotics on the Rise

Feb 9, 2012 1:31am

Wondering what could be the newest potential superbug? Gonorrhea, it seems.

A new editorial published in the New England Journal of Medicine highlighted the concern for the rising rate of antibiotic-resistant gonorrhea in the U.S.  The increases were most prominent in people living in the western United States and in men who have sex with men.

“There is much to do, and the threat of untreatable gonorrhea is emerging rapidly,” CDC authors wrote in the commentary.

Gonorrhea, caused by the bacteria Neisseria gonorrhoeae, is the second-most common communicable disease in the U.S. More than 600,000 Americans contract the infection each year. Symptoms, which include burning while urinating, discharge, and pain during intercourse, usually appear two to five days after contracting the infection, although in some instances a person who has contracted the infection will not experience any symptoms.

The sexually transmitted disease is currently treated with third-generation cephalosporin, an antibiotic. While the prevalence of resistance to the drug was about .1 percent in 2006, that number jumped to 1.7 percent by mid-2011, the editorial noted. The CDC first warned about antibiotic resistance among those who contracted gonorrhea in 2010.

But this isn’t the first time gonorrhea showed signs of drug resistance. During the 1940s and the 1980s, the infection showed resistance to the drugs treating the condition. But, the most jarring part of the problem, authors note, is that the antibiotic used today to treat the infection is the last one left among the recommended antibiotics by the CDC, when taken along with doxycycline or azithromycin, two other oral antibiotics.

“A major component of the threat is that there really is no backup plan if, most likely, when these more resistant organisms become more prevalent,” said Dr. Kenneth Fife, an infectious disease expert and professor of medicine at Indiana University Medical School. “There are very few new drugs that have activity against the gonococcus no clinical trials to establish the efficacy of the few drugs that might have promise.”

Because the infection can be symptomless, a person can easily and unwittingly spread the disease to others. Condoms protect against gonorrhea and other STDs.

“Based on history, it is unlikely we will be able to prevent an outbreak,” said Fife. “What we need is some new treatment options so we have a strategy for dealing with these more resistant strains once they become more common.”

If we do indeed find ourselves in a “post-antibiotic era,” Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center, said experts will be “hard-pressed to provide quick and effective therapy to patients.”

“There is no magic wand here and it’s going to require rigorous work,” said Schaffner. “Public health has to be able to reach out and contact sex partners of people with these resistant bugs.”

“These are routine things that we have to do exceedingly well to stop this from spreading and this is coming at a time when states and the federal government are cutting public health budgets,” said Schaffner.

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