Potential for untreatable gonorrhea?

This Monday, 10 Oct. 2011, doctors from the United Kingdom reported that gonorrhea has developed an increased resistance to the antibiotic currently used to treat it. The UK Health Protection Agency (HPA) recommended a change in treatment protocol earlier this year due to the “alarming rise in resistance.”

The Health Protection Agency documented a reduction in susceptibility to cefixime, a cephalosporin drug, by 10% since 2010. Gonorrhea, a sexually transmitted disease (STD) caused by the Neisseria gonorrhoeae bacterium, is the second most common bacterial sexually transmitted disease in the UK.

Gonorrhea developed resistance to penicillin and tetracycline in the 1980s in the United States. Since then, the Centers for Disease Control and Prevention (CDC) has recommended cephalosporin drugs with either doxycycline or azithromycin as treatment.

This summer, an international team of scientists discovered a strain of gonorrhea from Japan (named H041) that is resistant to all known antibiotics. One of the scientists from the team, Dr. Magnus Unemo, called the finding simultaneously predictable and alarming. Predictable because gonorrhea is a bacterial disease and bacteria evolve and develop resistance to antibiotics over time. For example, of great concern to the public health and medical world is the development of multidrug resistant tuberculosis (MDR-TB). Previously a problem limited to certain countries in Africa, Eastern Europe and parts of Asia, cases of active MDR-TB were recently discovered in an impoverished Paris suburb, forcing the world to recognize the influence of social and economic factors on infectious disease, as well as the seriousness of the potential for these superbugs to spread. 

Yet, this discovery is also alarming because of the prevalence of this STD. As stated, gonorrhea is the second most common bacterial STD in the UK. The CDC reports approximately 700,000 new infections a year in the United States alone. Further, untreated gonorrhea can have serious health affects. Gonorrhea is a common cause of pelvic inflammatory disease (PID) in women. Pelvic inflammatory disease damages a woman’s fallopian tubes, which can cause pregnancy complications and increase the risk of infertility. Men with untreated gonorrhea are also at risk of infertility as gonorrhea can cause epididymitis, a condition affecting the ducts attached to the testicles.    

The real problem with bacterial evolution is that if new antibiotics are not found, gonorrhea could become untreatable.

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