Going, going, gonorrhea

Antibiotic-resistant sexually transmitted infections on the rise

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Three antibiotic-resistant strains of gonorrhea, also known as superbugs, have been discovered recently. Courtesy of stevepb through Pixabay

Three antibiotic-resistant strains of gonorrhea, also known as superbugs, have been discovered in Spain, Japan and France.

New data from the World Health Organization shows that gonorrhea, a common sexually transmitted disease, is becoming increasingly difficult to treat with antibiotics, and in some cases treatment has become impossible.

“The bacteria that cause gonorrhoea [an alternative spelling of gonorrhea] are particularly smart,” said Dr. Teodora Wi, medical officer, Human Reproduction, at WHO. “Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.”

WHO reports statistics from 77 different countries and has found antibiotic-resistant gonorrhea is both widespread and particularly resistant to older and cheaper antibiotics.

“In some countries antibiotics are over the counter,” said Mark Bajorek, medical director at Center for Student Health and Counseling. “Patients can treat themselves with inadequate doses for an abbreviated course of treatment. Bacteria that survive the antibiotics can share their DNA to neighboring bacteria through bridges called pili. These recipient bacteria will then be resistant to the antibiotic, as well.”

According to WHO, approximately 78 million people are infected with gonorrhea each year. Complications from untreated gonorrhea include pelvic inflammatory disease, increased risk of HIV, infertility, and ectopic pregnancy in women.

WHO Global Gonococcal Antimicrobial Surveillance is continuing to monitor trends in drug-resistant strains. In most countries, extended-spectrum cephalosporins are the only remaining effective treatment to gonorrhea, but emergence of resistance to ESC has been reported. As a result, in 2016 WHO issued an updated global treatment that requires two antibiotics.

“Microbes are living things that can adapt to harsh environments. We have to continue to monitor drug resistance for gonorrhea and for any infectious agents,” Bajorek said. “Currently we treat gonorrhea with a two-drug therapy [azithromicin and ceftriaxone] to cover resistant strains. Multnomah County also maintains surveillance of communicable diseases.”

WHO is partnering with the Drugs for Neglected Diseases Initiative to launch the Global Antibiotic Research and Development Partnership, addressing the issue of antibiotic resistant gonorrhea through development of new drugs.

Bajorek said eventually, antibiotic-resistant strains of gonorrhea will spread to the U.S. and close monitoring and proper precautions are important in dealing with drug-resistant gonorrhea.

“The key is to monitor affected patients and have treated patients return to the clinic for a test of cure a month or so later,” Bajorek said. “Clinics also report the occurrence of resistant bacteria to the local county health authorities.”

When it comes to addressing the spread of antibiotic-resistant gonorrhea, prevention is key. When taking on new partners, Bajorek encourages students to test for gonorrhea, including mouth, genital and rectum, prior to sexual activity, as well as to use condoms and dental dams to prevent the spread of gonorrhea.

“PSU students are pretty savvy about getting STI visits through SHAC, the county, Planned Parenthood, or their own provider,” Bajorek said. “If there were a resistant strain that came to Portland, healthcare workers are mandated to report this; the county sends healthcare providers updates, and we would adjust the type of antibiotic regimen to treat the newly resistant gonorrhea.”

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