Drug-Resistant 'Super-Gonorrhea' Is Here

This particularly sinister new strain of gonorrhea (sometimes spelled gonorrhoea) doesn’t respond to any known conventional gonorrhea regimens, making it particularly hard, and in some cases “impossible” to treat.         

Sound familiar?

An unidentified heterosexual British male has been confirmed as patient zero, or at least the first confirmed case of the disease, according to Time Magazine and a case report from the U.K.’s public health department, the Department of Health & Social Care. The man’s strain of gonorrhea didn’t respond to azithromycin, a common antibiotic often prescribed for gonorrhea and many other infections, or even ceftriaxone, one of the most common last-resort drugs for gonorrhea. Azithomycin is also used for middle ear infections, strep throat, pneumonia and unpredictable bowel movements.

The man is now being treated with an intravenous course of ertapenem, a powerful antibiotic typically used for “serious infections in hospitalized patients” in America,  according to the National Institutes of Health. No one knows yet how the man will respond to ertapenem, or if he’ll respond to it at all. He is also being treated with the antibiotic spectinomycin. An outcome is expected to be released come mid-April.

The World Health Organization (WHO) apparently has already been concerned about drug-resistant strains of gonorrhea for some time, and sounded the alarm on July 7, 2017. "The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them," warned Dr. Teodora Wi, Medical Officer, Human Reproduction, at WHO. Since then, a strain of gonorrhea has been growing in strength.

Dr. Marc Sprenger, Director of Antimicrobial Resistance at WHO said in the report that the medical community needs “new tools and systems for better prevention” of gonorrhea.

“This report is one more confirmation of our greatest fear: drug-resistant gonorrhea spreading around the globe,” David Harvey, executive director of the National Coalition of STD Directors, told CNN in response to the WHO report.

WHO officials estimate that gonorrhea, which is one of the world’s most common sexually transmitted infections (STI), affects 78 million people globally each year.

The WHO Global Gonococcal Antimicrobial Surveillance Programme (WHO GASP), monitors trends in drug-resistant gonorrhea. WHO GASP found an alarming increases in both a resistance to azithromycin and a resistance to the extended-spectrum cephalosporins (ESCs) oral cefixime or injectable ceftriaxone.

A September 26, 2017 report from the Centers for Disease Control and Prevention (CDC) estimated that 470,000 Americans were diagnosed with gonorrhea in 2016 alone. The CDC reported a surge of over 2 million new cases of gonorrhea and other STIs including chlamydia, gonorrhea and syphilis in the United States. That brings the CDC global estimates close to 20 million total annual STI infections.

Untreated (or untreatable) gonorrhea can cause pelvic inflammatory disease, ectopic pregnancy, infertility and an increased risk of HIV. Gonorrhea, however, is extremely common among young people, especially those ages 15-24 years.

Gonorrhea, like HIV, is only controllable if the drug regimens work. Drug resistance in HIV ranks among the top challenges that medical science is faced with today. Drug resistant strains mutate and adapt to anything that doctors can prescribe. Cross resistance is when a strain of HIV or other STI becomes resistant to a whole class of drugs.

Getting people to adhere to general safe sex practices can prevent the disease from becoming a serious one. Using condoms and using common sense is what can reduce infection rates for gonorrhea and other STIs.