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US investigates first 'troubling' cases of new drug-resistant gonorrhea strain

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Massachusetts health officials announced Thursday that they had identified two cases of a new strain of gonorrhea that appears to have developed resistance to a wide range of antibiotic treatments.

Both patients improved after receiving injections of ceftriaxone, the main drug currently recommended to treat cases of sexually transmitted infection. But state health officials warn that the strain that infected them shows signs of at least some resistance to nearly all drugs used to treat the bacteria, the first of its kind confirmed in the US so far.

Investigators are now working with the Centers for Disease Control and Prevention to test other samples collected from gonorrhea cases in the state. Massachusetts is also conducting contact tracing to find out if the drug-resistant strain has spread to other people.

“The discovery of this strain of gonorrhea is a serious public health concern that DPH, the CDC and other health departments have been vigilant about detecting,” Margret Cooke, head of the Massachusetts Department of Public Health, said in a statement Thursday. -fair.

Gonorrhea is the second most common sexually transmitted infection reported to health authorities in the US, behind chlamydia, according to the CDC.

Many who are infected by the bacteria usually have little or no symptoms. However, some may develop bleeding, discharge, and more serious complications that can lead to infertility and pain.

The initial case was identified in a patient who went to a basic health unit with symptoms of urethritis, a kind of irritation that can make urination difficult. Samples examined by the state health laboratory signaled a “worrying” pattern later verified by follow-up testing by the CDC.

A state spokesperson declined to clarify additional details about the two cases beyond those identified in the department’s statement and alert to providers.

No direct connection has been identified between the two cases. One of them had no recent travel history, suggesting the tension could be spreading within the state.

“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,” Cooke said.

The ‘alarming’ drug resistance of gonorrhea

For years, health authorities have been working to respond to the “alarming” ability of gonorrhea to develop resistance against antibiotics that have been implanted. to fight it.

In 2013, the CDC named gonorrhea one of the three most pressing threats posed by antibiotic-resistant bacteria. US and global health officials have launched campaigns to curb new cases of gonorrhea in hopes of controlling the bacteria until vaccines and new treatments are developed.

The Massachusetts cases are the first laboratory-confirmed cases that have developed the ability to bypass six of the seven drugs that health officials screen for potential resistance. It carries an alteration in the “penA60 allele” – a genetic mutation – that has been linked to previous cases of ceftriaxone resistance in Nevada, the UK and Asia.

“This case is a reminder that antimicrobial-resistant gonorrhea remains an urgent public health threat nationally and internationally; all providers in all clinical settings need to remain vigilant,” Dr. Laura Hinkle Bachmann, medical director of the CDC’s Division of STD Prevention, said Thursday in a letter to providers.

Ceftriaxone injections, boosted with other oral antibiotics like azithromycin and doxycycline, were the last recommended treatment for gonorrhea since 2012. At the time, laboratory data showed that a related drug known as cefixime was losing effectiveness and was at risk of creating resistance to ceftriaxone as well .

Only one drug tested against the Massachusetts strain by the CDC panel – gentamicin – showed no signs of reduced susceptibility. However, this drug is already generally considered a less effective treatment for gonorrhea.

Scientists have been looking for new drugs for gonorrhea, such as zoliflodacin, which showed promising initial results in a 2018 study supported by the National Institutes of Health. This medication is currently being studied in clinical trials and has not been approved by the Food and Drug Administration for gonorrhea.

“Timely identification and treatment, as well as a rapid public health response, are essential to keeping patients safe and reducing the risk of community transmission. We must all remain alert to potential gonococcal treatment failures as we combat the growing threat of resistance antimicrobial,” Bachmann said.