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Super gonorrhea has arrived in the US

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An illustration of the bacterium Neisseria gonorrhoeae.

an illustration of Neisseria gonorrhoeae bacteria.
Illustration: Shutterstock (Shutterstock)

Super gonorrhea infected people in the United States for the first time. This week, Massachusetts public health officials announced the discovery of two cases of gonorrhea that appear to show increased resistance to all known classes of antibiotics that can be used against it. Thankfully, those cases were still curable, but it’s the latest reminder that this common sexually transmitted infection is becoming a more serious threat.

Gonorrhea, caused by the homonymous bacteria Neisseria gonorrhoeaeit is the second most commonly reported STD in the US, with 677,769 cases documented in 2020. Many infected people do not have the disease, but early symptoms may include a discolored discharge from Organs genitals, pain or burning when urinating, and rectal bleeding if detected during anal sex. When gonorrhea is not treated, it increases the risk of more serious complications, such as damage to the reproductive tract in women and swollen testicles in men, both of which can lead to infertility. And when it is transmitted from mother to child, the infection can be fatal or cause blindness in newborns.

Although gonorrhea was once easily treated with a simple penicillin pill or other antibiotics, the bacteria constantly learned resist nearly every drug thrown your way. Currently, only one or two antibiotics taken at the same time (depending on the region) are considered effective against gonorrhea and are recommended as first-line treatments. But in recent years, doctors have seen cases of gonorrhea in which she began to escape even these drugs. These largely resistant or pan-resistant infections have been documented in parts of Europe and Asia to date, but at least two similar cases have been identified in Massachusetts.

According to the state health department, the gonorrhea strain isolated from one case clearly showed resistance or a reduced response to five classes of antibiotics, while the strain extracted from the second case was genetically close enough to likely have similar resistance. A common genetic marker seen in these cases was previously identified in a reported case from Nevada, but this strain still responded normally to at least one class of antibiotics. As far as health authorities are aware, these are the first documented cases of gonorrhea to show increased resistance to all classes of drugs known to treat it ever identified in the US.

“The discovery of this strain of gonorrhea is a serious public health concern that DPH, the CDC and other health departments have been vigilant to detect in the US,” said Public Health Commissioner Margret Cooke in a statement. declaration from the agency.

Rising rates of resistance to the antibiotic azithromycin led the US to stop recommending it for gonorrhea at the end of 2020. Now, only the drug ceftriaxone – taken as an injection – is considered a front-line option in the country and at a higher dose than than before. Fortunately, despite the reduced response to ceftriaxone, both cases successfully resolved after patients took these higher doses.

These cases are probably just a warning of things to come. Some of the important genetic markers seen in this new strain were detected in pan-resistant cases from Europe and Asia, which shows that these mutations continue to spread around the world. Gonorrhea rates in general have increased year after year in the US And perhaps most worryingly, no clear connection between the two Massachusetts cases was found, indicating that these strains may already be circulating beyond the point where they could be easily contained.

There are ongoing efforts to develop vaccines and new antibiotics against gonorrhea, but it could be years before any, if any, come to fruition. Therefore, it has become increasingly important to take precautions against contracting and spreading these STDs in the first place. Health authorities are now warning physicians and testing laboratories in Massachusetts to look for and report similar cases.

“We urge all sexually active people to be regularly tested for sexually transmitted infections and to consider reducing the number of sexual partners and increasing the use of condoms when having sex. Clinicians are advised to review the clinical alert and assist with our expanded surveillance efforts,” said Cooke.