February 8, 2023

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

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(CNN) — Public health authorities in the United States say they have found two cases of gonorrhea that appear to have reduced susceptibility to every type of antibiotic available to treat them. It is the first time that gonorrhea strains so resistant to antibiotics have been identified in the country.

Increased sexual activity during the pandemic, coupled with fewer people getting routine health exams, fueled the spread of sexually transmitted infections around the world.

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

Globally, antibiotic-resistant infections kill approximately 700,000 people each year. That number is expected increase 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 if this highly resistant strain of gonorrhea would reach the US, but rather when.

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

“It is a reminder that gonorrhea is becoming more and more resistant, more and more difficult to treat. We don’t have new antibiotics. We haven’t had new antibiotics to treat gonorrhea for years and we really need a different treatment strategy,” said Klausner, who is part of the US Centers for Disease Control and Prevention (CDC) task force. for the treatment of gonorrhea.

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

People can become infected and have no 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, gonorrhea strains identified in Massachusetts also showed reduced susceptibility to cefixime and azithromycin; the strains were resistant to ciprofloxacin, penicillin and tetracycline, according to a clinical alert sent to doctors by the Massachusetts Department of Public Health (MDPH).

The MDPH he says he has yet to find any connection between the two cases.

In 2021, the CDC recommended a double dose of the antibiotic ceftriaxone in an effort to overcome bacterial resistance to this antibiotic, and that seems to have worked in these cases, but that antibiotic is the last line of defense against this infection, and experts say a new approach is needed.

Klausner hopes to win FDA approval for a test that would tailor antibiotic treatment to the genetic susceptibilities of the particular strain of gonorrhea that infects a person. This is called resistance-guided treatmentand Klausner says it works for HIV, tuberculosis, and some other hospital-acquired infections, but it’s never really been tested for gonorrhea.

This strain of gonorrhea has previously been seen in Asia-Pacific countries and the UK, but not the US. 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 CDCmaking routine exams important to detect infection.



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