Public health officials have discovered two cases of gonorrhea that appear resistant to every antibiotic available to treat them. It is the first-time antibiotic-resistant gonorrhea strains have been identified in the United States.
Increased sexual activity during the pandemic and fewer people receiving routine health screenings hastened the spread of sexually transmitted infections. These infections, including gonorrhea, are becoming increasingly resistant to the antibiotics available to treat them, posing a severe threat to public health.
Antibiotic-resistant infections kill approximately 700,000 people worldwide each year. If steps are not taken to stop the spread of resistant organisms, that figure is expected to rise to 10 million deaths annually by 2050. According to experts, it was never a question of if but of when this highly resistant gonorrhea strain would arrive in the United States.
“The concern is that this particular strain has been circulating the world, so it was only a matter of time before it would hit the U.S.,” says Dr. Jeffrey Klausner of the University of Southern California’s Keck School of Medicine in Los Angeles.
“It’s a reminder that gonorrhea is becoming increasingly resistant, increasingly hard to treat. There are no new antibiotics available. We haven’t had new antibiotics to treat gonorrhea in years, and we need a different treatment strategy,” said Klausner, a member of the CDC’s gonorrhea treatment workgroup.
Gonorrhea is a sexually transmitted infection among the most commonly diagnosed diseases in the United States. The bacteria Neisseria gonorrhoeae causes it, and it can infect the mucous membranes of the genitals, rectum, throat, and eyes. People can be infected without showing any signs of illness. If left untreated, the infection can lead to pelvic pain, infertility, and blindness in newborns.
According to a clinical alert that was sent to physicians by the Massachusetts Department of Public Health, the strains of gonorrhea identified in Massachusetts showed reduced susceptibility to ceftriaxone, cefixime, and azithromycin, as well as resistance to ciprofloxacin, penicillin, and tetracycline. According to the MDPH, no link between the two cases has been established.
The US Centers for Disease Control and Prevention recommended giving a double dose of the antibiotic ceftriaxone to overcome the bacteria’s building resistance to this antibiotic in 2021, which appears to have worked in these cases. Still, that antibiotic is the last line of defense against this infection, and experts say a new approach is required.
Klausner is attempting to gain FDA approval for a test that would tailor antibiotic treatment to the genetic susceptibilities of the gonorrhea strain infecting a person. It is a resistance-guided treatment, and Klausner claims it works for HIV, tuberculosis, and other hospital-acquired infections, but it has never been tried for gonorrhea.
This strain of gonorrhea has previously been observed in Asia-Pacific countries and the United Kingdom but not in the United States. Genetic marker in both of these Massachusetts residents was also found in a case in Nevada, though that strain retained sensitivity to at least one class of antibiotics.
According to the CDC, the first symptoms of gonorrhea are often painful urination, abdominal or pelvic pain, increased vaginal discharge, or bleeding between periods. However, many infections are asymptomatic, making routine screenings important for catching the disease.
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