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First cases of gonorrhea resistant to several classes of antibiotics identified in the US

First cases of gonorrhea resistant to several classes of antibiotics identified in the US

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CNN

Public health officials say they have found two cases of gonorrhea that appear to have reduced susceptibility to every type of antibiotic available for treatment. This is the first time that strains of gonorrhea that are so resistant to antibiotics have been identified in the United States.

Increased sexual activity during the pandemic, coupled with fewer people undergoing routine health screenings, increase the spread sexually transmitted infections worldwide.

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

Globally, infections that are resistant to antibiotics kill approximately 700,000 people each year. This number is is expected to rise up to 10 million deaths per year by 2050 if steps are not taken to stop the spread of resistant organisms.

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

“The concern is that this particular strain is circulating around the world, so it was only a matter of time before it hit the US,” said Dr. Jeffrey Klausner, a clinical professor of public health at the University of Southern California Keck School of Medicine in Los Angeles.

“This is a reminder that gonorrhea is becoming more resistant and harder to treat. We have no new antibiotics. We haven’t had new antibiotics to treat gonorrhea in years, and we really need a different treatment strategy,” said Klausner, who is on the CDC’s gonorrhea treatment task force.

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

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

In addition to reduced susceptibility to ceftriaxone, the gonorrhea strains identified in Massachusetts also showed reduced susceptibility to cefixime and azithromycin; 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 has yet to find any 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 development of bacterial resistance to this antibiotic, and it seems to have worked in these cases, but this antibiotic is the last line for defense against this infection, and experts say a new approach is needed.

Klausner hopes to get FDA approval for a test that would tailor antibiotic treatment to the genetic susceptibility of the particular strain of gonorrhea that infects a person. That’s what it’s called resistance-targeted treatmentt, and Klausner says it works for HIV, tuberculosis and some other hospital-acquired infections, but it has never been tried for gonorrhea.

This strain of gonorrhea has previously been seen in Asia-Pacific countries and the United Kingdom, but not in the United States. A genetic marker common to these two Massachusetts residents was also previously seen in a case in Nevada, although that strain retained susceptibility 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 many infections are asymptomatic. According to the CDCwhich makes routine examinations important to catch the infection.


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