Super gonorrhea has reached the United States

An illustration of the Neisseria gonorrhoeae bacteria.

An illustration of Neisseria gonorrhoeae bacteria.
Drawing: Shutterstock (Shutterstock)

Super gonorrhea has infected people in the United States for the first known time. This week, Massachusetts public health officials announced the discovery of two cases of gonorrhea that appear to display increased resistance to all known classes of antibiotics that can be used against it. These cases were fortunately still curable, but this is the latest reminder that this common sexually transmitted infection is becoming a more serious threat.

Gonorrhea, caused by the homonymous bacteria Neisseria gonorrhoeaeis the second most commonly reported STI in the United States, with 677,769 cases documented in 2020. Many infected people are not sick, but early symptoms may include discolored discharge from the genitals, painful or burning urination, and rectal bleeding if caught during anal sex. When gonorrhea is left untreated, it increases the risk of more serious complications, such as reproductive tract damage in women and swollen testicles in men, both of which can lead to infertility. And when passed from mother to child, the infection can be fatal or cause blindness in newborn babies.

While gonorrhea was once easily treatable with a simple penicillin pill or other antibiotics, the bacteria has learned regularly resist almost any drug thrown its way. Nowadays, only one or two antibiotics taken at the same time (depending on the region) are considered effective against gonorrhea and are recommended as first-line treatments. But in recent years, doctors have seen cases of gonorrhea where he has started to evade even these drugs. These extremely resistant or pan-resistant infections have been documented in parts of Europe and Asia to date, but at least two similar cases have now been identified in Massachusetts.

According to the state health department, the gonorrhea strain isolated from one case clearly showed resistance or reduced response to five classes of antibiotics, while the strain extracted from the second case was genetically close enough to have probably a similar resistor. A common genetic marker seen in these cases has previously been identified in a case reported in Nevada, but this strain still responded normally to at least one class of antibiotics. To health officials’ knowledge, these are the first documented cases of gonorrhea to show increased resistance to all classes of drugs known to treat it ever identified in the United States.

“The discovery of this strain of gonorrhea is a serious public health concern that DPH, CDC and other health departments have been working to detect in the United States,” said Public Health Commissioner Margret Cooke. in a press release. statement of the agency.

Rising rates of resistance to the antibiotic azithromycin led the United States to stop recommending it for gonorrhea at the end of 2020. Now only the drug ceftriaxone – taken as an injection – is considered an option for first line in the country, and at a higher dose than before. Fortunately, despite the reduced response to ceftriaxone, both cases were successfully cleared after the patients took these higher doses.

These cases are probably only a warning of what is to come. Some of the important genetic markers seen in this new strain have been spotted in pan-resistant cases from Europe and Asia, showing that these mutations continue to spread around the world. Gonorrhea rates in general have increased year after year in the United States And perhaps most worryingly, no clear link between the two Massachusetts cases has been found, indicating that these strains may already be circulating beyond the point where they can be easily contained.

Efforts are underway to develop vaccines and new antibiotics for gonorrhea, but it may take years for any of them to come to fruition, if any. It has therefore become more important to take precautions against contracting and spreading these STIs in the first place. Health officials are now to alert Massachusetts doctors and testing labs to research and report any similar cases.

“We urge all sexually active people to be tested regularly for sexually transmitted infections and to consider reducing the number of their sexual partners and increasing their use of condoms during sex. Clinicians are encouraged to review the clinical alert and participate in our expanded surveillance efforts,” Cooke said.

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