Gonorrhea became unstoppable. Highly resistant cases found in the United States


Colored scanning electron micrographs of the bacterium Neisseria gonorrhoeae, which causes gonorrhea.

Colored scanning electron micrographs of the bacterium Neisseria gonorrhoeae, which causes gonorrhea.

The most drug-resistant gonorrhea cases detected in the United States to date occurred in two unrelated individuals in Massachusetts, state health officials announced Thursday.

These cases are the first time that an American has been isolated from the bacteria that causes gonorrhea. Neisseria gonorrhoeaeThey showed complete resistance or reduced susceptibility to all drugs recommended for treatment.

Fortunately, both cases were successfully treated with powerful injections of the antibiotic ceftriaxone, although bacterial isolates showed reduced sensitivity to the drug. Ceftriaxone is currently the recommended frontline treatment for sexually transmitted infections.

But health officials said the cases are a warning. “N. gonorrhoeae become less responsive to a limited arsenal of antibiotics.”

fermentation resistance

for years, Global Observation Data Compiled by the World Health Organization showed that gonorrhea is becoming more and more resistant to a whole host of drugs, including frontline drugs like ceftriaxone. Although monitoring is spotty globally, A study of WHO data 2017-2018 Published in 2021 found N. gonorrhoeae Isolates with reduced sensitivity or resistance to ceftriaxone appeared in 21 of the 68 reporting countries, or 31 percent.

Resistance against alternative antibiotics was even higher. Of the 61 countries that reported data on an alternative antibiotic, azithromycin, 51 countries (84 percent) reported resistance. Of the 51 countries that reported data on the alternative antibiotic treatment, cefixime, 24 (47 per cent) reported resistance. For ciprofloxacin, an antibiotic that has been largely abandoned as a treatment for gonorrhea due to resistance, all 70 reporting countries found resistance.

“In many countries, resistance to ciprofloxacin is very high, resistance to azithromycin is increasing rapidly, and resistance to or reduced susceptibility to ceftriaxone and cefixime persists,” WHO said in 2021. It will be difficult to treat and cure.”

The agency was not exaggerated. Last year, the World Health Organization added that reports Gonorrhea treatment failure pile up. The World Health Organization states that “in the past decade, confirmed failures in the treatment of gonorrhea with ceftriaxone alone or in combination with azithromycin or doxycycline have been reported in Australia, France, Japan, Slovenia, Sweden and the United Kingdom of Great Britain and Northern Ireland”.

An isolate reported in Massachusetts yesterday showed reduced susceptibility to ceftriaxone, cefixime and azithromycin and resistance to ciprofloxacin, penicillin and tetracycline in laboratory testing. The Massachusetts Department of Public Health reports that the second isolate appears to have a similar profile based on genetic data. This strain N. gonorrhoeae It has been circulating in Asia Pacific countries and has been detected in recent cases in the UK.

high cases

Besides the worrying trend of increasing resistance, there is the fact that gonorrhea cases are high worldwide and increasing in the United States. In 2020, the World Health Organization estimated that there were 82.4 million new cases of gonorrhea worldwide. In the United States, there were nearly 700,000 cases in 2021, up More than 25 percent from 2017According to preliminary estimates from the Centers for Disease Control and Prevention.

In many people, there are no symptoms of gonorrhea. In other cases, it is so mild that it may be mistaken for a minor bladder infection or a fungal infection. However, over time, it can lead to pelvic inflammatory disease, severe pain, and fertility problems. Health officials stress the need for testing and monitoring to treat infections early on, before they become severe and have a chance of spreading.

In my Massachusetts case, health officials are now working on contact tracing. Without a clear link between the two cases, officials say it is likely more widespread than currently known.

“The discovery of this strain of gonorrhea is such a serious public health concern that the Department of Public Health, the CDC and other health departments have been cautious about its discovery in the United States,” Massachusetts Public Health Commissioner Margaret Cooke said in a statement. “We urge all sexually active people to have regular screenings for STDs and to consider reducing the number of their sexual partners and increasing their use of condoms when having sex. Physicians are advised to review the clinical alert and assist with our expanded surveillance efforts.”



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