The symptoms of the new strain of gonorrhea are much more difficult to detect, even for the sufferer. ‘Old’ gonorrhea of the urethra caused acute pain often described as like ‘passing razor blades. However, the new strain is nowhere near as painful and only detectable by the discharge simultaneous with urination. This increases the chances of the infection going undiscovered and untreated. STDs can be prevented by only having protected sex and including sexual partners in any diagnosis and early treatment.
The New Yorker discusses the connection between gonorrhea a.k.a. “the clap” and oral sex:“A driving factor behind the rise in gonorrhea infections, as well as the trend toward total antibiotic resistance, is our complacent attitude toward oral sex. Saliva contains enzymes that destroy gonorrhea, so kissing and cunnilingus don’t spread it. But fellatio, which brings the tip of the urethra near the pharynx, carries a high risk of infecting one partner or the other. According to Dr. Peter Rice, a gonorrhea expert at the University of Massachusetts Medical School in Worcester, fellatio ‘is the only predictable way to transmit gonococcal infection to the pharynx.’”“The emerging drug-resistant strains of gonorrhea are most common among commercial sex workers and men who have sex with men, perhaps because these groups are more likely to be infected repeatedly. But the wider picture is more complex … The adaptive nature of the gonococcus, coupled with the prevalence of unprotected oral sex, all but insures that drug-resistant gonorrhea will eventually take root in the general heterosexual population.”
From a once easily treatable infection, gonorrhoea has evolved into a challenging disease, which in future may become untreatable in certain circumstances. International spread of extensively drug-resistant gonococci would have severe public health implications. It seems clear that under the current treatment pressure from extended-spectrum cephalosporins, and owing to Neisseria gonorrhoeae’s remarkable evolutionary adaptability, further rise of ceftriaxone-resistant strains around the world is inevitable. Simply increasing the doses of extended-spectrum cephalosporins will likely prove ineffective in the long run, and has been a lesson learnt for all single-agent therapies used for gonorrhoea to date. We recommend that dual therapy, especially those consisting of extended-spectrum cephalosporins and azithromycin, be adopted more widely and complemented by strengthening of antimicrobial resistance surveillance. Unless there is urgent action at international and local levels to combat the problem of N. gonorrhoeae antimicrobial resistance, we are in for gloomy times ahead in terms of gonorrhoea disease and control.
Gonorrhea is the second most commonly reported infectious disease in the U.S. Only one class of drugs, called cephalosporins—cefixime and ceftriaxone—is known to reliably treat it, and for several years resistance to cefixime has been rising. Some public-health officials predict that in five to eight years the superbug will be widespread. In the U.S., gonorrhea in general is linked to poverty and youth
Federal health officials took steps Thursday to head off the emergence of a new gonorrhea “superbug” that’s resistant to standard antibiotics.
Gonorrhea, a sexually transmitted disease that infects 700,000 Americans a year, already has become resistant to all but one class of antibiotics and could soon become untreatable, federal health officials warned. Doctors at the Centers for Disease Control and Prevention issued new treatment guidelines, hoping to delay the inevitable day when standard drugs no longer work. The guidelines call for withholding a potent oral antibiotic now commonly used to treat the infection. Instead, doctors should use an injectable form to which the gonorrhea bacteria seems less likely to develop resistance, along with a second type of antibiotic pills.
Exactly 6 months after warning, in a major medical journal, that gonorrhea was becoming untreatable by the last two drugs commonly used against it, the Centers for Disease Control has taken one of those drugs off the table, leaving just one antibiotic available to treat the disease.
In a bulletin published today, the public health agency says that data from the national Gonococcal Isolate Surveillance Project shows a high enough percentage of resistance to the oral cephalosporin cefixime that “CDC no longer recommends cefixime at any dose as a first-line regimen for treatment of gonococcal infections.” Instead, it says, physicians should administer a single dose of injectable ceftriaxone, accompanied by some additional oral drugs.
For decades, gonorrhea patients could expect to quickly dispatch the long-dreaded sexually transmitted disease with a time-tested round of antibiotics.
On Thursday, officials with the Centers for Disease Control and Prevention (CDC) are scheduled to release new treatment guidelines to slow the growth of antibiotic-resistant gonorrhea in the United States.
These guidelines are coming none too soon, said William Smith, executive director of the National Coalition of STD (Sexually Transmitted Disease) Directors.
“It is pretty clear that we have already seen significant resistance to the existing [gonorrhea] treatments, and internationally, we have seen complete treatment failures,” he said. “So right now is the time to be just ahead of this, and to try and figure out how we can control it a bit longer with the existing resources that we’ve got.”
Highly resistant gonorrhea — which is to say, gonorrhea that has already become resistant to sulfa drugs, penicillin, tetracycline, and fluoroquinolones such as Cipro, and that is gaining resistance to cephalosporins — first emerged in Japan and over the past decade was carried to the western United States, and then crossed the country. But a recent issue of EuroSurveillance, the journal of the European Centre for Disease Prevention and Control, warns that cases are now increasing in Europe, and exhibiting resistance against the last drug that both worked and was uncomplicated to use.To make sense of this news, it helps to know that effective STD control depends on drugs that are inexpensive, effect a cure in one or a small number of doses, and are easy to administer or take
Recent data indicate an increasing resistance to ciprofloxacin in Neisseria gonorrhoeae, especially among men who have sex with men.See Also Syphilis testing rates increased among adolescents … Chlamydia screening increased from 2000-2006, decreased … Dual prevalence of malaria, STIs observed in sub-Saharan …“As treatment failures for oral cephalosporins are documented in Asia, and strains with reduced susceptibility to cephalosporins have begun to appear in the West, including the United States, the origins and causes of increased drug resistance in N. gonorrhoeae need to be understood in order to improve control measures for emerging resistant strains and thereby maintain the utility of the few existing antimicrobial drug options for treatment of gonorrhea,” the researchers wrote.
More untreated gonorrhea has consequences beyond annoyances of painful urethritis. Klausner thinks this could mean more pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancies and infertility in women. To the extent that gonorrhea amplifies HIV transmission, this could also mean an increase in HIV incidence in some populations. For now, Klausner echoes the CDC recommendation that all gonorrhea cases should be treated with dual therapy — injectable ceftriaxone plus either azithromycin or doxycycline even if chlamydia is not concomitantly diagnosed.