New health threat: a sexually transmitted superbug deadlier than AIDS

Drug resistant gonorrhoea strain poses public health crisis; US Centers for Disease Control requests funds to research new antibiotics for treatment

By Kundan Pandey
Published: Tuesday 07 May 2013

A new sexually transmitted strain of gonorrhoea may become deadlier than AIDS, warn doctors in the United States. The strain of gonorrhoea has proved resistant to antibiotics and is now considered a superbug.

The strain, HO41, commonly named gonorrhoea, was first discovered in Japan in 2011 in a 31-year-old female sex worker. Though the disease has not yet caused any fatalities, the US Centers for Disease Control and Prevention (CDC) has asked Congress for $53.48 million to find an antibiotic to treat the strain. CDC claims that the anti-biotic resistance nature of gonorrhoea could lead to a crisis if precautionary measures are not taken.

“Gonorrhoea is the second most commonly reported communicable disease in the United States. Gonorrhoea has developed resistance to every class of antibiotics recommended for its treatment; we are now on our last line of defence to treat this disease that is a major cause of pelvic inflammatory disease, ectopic pregnancy, and infertility and can facilitate HIV transmission,” says William Smith, executive director, National Coalition of STD Directors.

"Experts agree that it's not a matter if gonorrhoea resistance will hit, it's a matter of when it will hit," says Smith. “If we aren't prepared when it happens we will have a serious public health crisis our hands, with only a lack of attention and investment to blame," he adds.

The concern of the CDC is valid considering the organisation recommended the use of ceftriaxone, and injectable anti-microbial and the last drug used to treat gonorrhoea, in updated gonorrhoea treatment guidelines released in August last year.

Researchers Magnus Unemo and Robert A Nicholas, in their paper on multi-drug resistant gonorrhoea published in the journal Future Microbiology in December last year, warned, “An era of untreatable gonorrhoea may be approaching, which represents an exceedingly serious public health problem.”
The researchers point out that the new superbug Neisseria gonorrhoeae has retained resistance to antimicrobials previously recommended for first-line treatment. The strain has now demonstrated its capacity to develop resistance to other extended-spectrum antibiotics cephalosporin and ceftriaxone. These drugs are the last remaining option for first-line empirical treatment of gonorrhoea.

The National Coalition of STD Directors, in an emergency funding request to Congress, write, “Untreated gonorrhoea causes serious, painful and costly medical conditions in both men and women. In women, gonorrhoea can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). PID is a leading cause of infertility and can increase the risk of ectopic pregnancy. In men, gonorrhoea may be complicated by epididymitis, which may also lead to infertility. If left untreated, gonorrhoea can also spread to the blood and cause disseminated gonococcal infection—which can be life threatening, infecting the joints, the skin, the heart valves and even the brain.”


Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae

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