‘Untreatable,’ Antibiotic-Resistant Gonorrhea is on the Rise, Warns WHO

In case you needed another reason to practice safe sex, the World Health Organization is reporting that gonorrhea is becoming “much harder, and sometimes impossible, to treat,” thanks to antibiotic resistance.

“The bacteria that cause gonorrhea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them,” said Dr. Teodora Wi, Medical Officer, Human Reproduction, at the WHO.

After analyzing data from 77 countries, the WHO concluded there is widespread resistance to older and cheaper antibiotics, with cases in Japan, France and Spain—particularly high-income countries—that were completely untreatable. Dr. Wi notes these cases “may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common.” Yikes.

This “superbug gonorrhea,” which has been dubbed a “serious situation” by the WHO, has been attributed to decreased condom use, increased urbanization and travel, poor infection detection rates and inadequate or failed treatment. And, according to Dr. Wi, gonorrhea bacteria transmitted through oral sex is particularly concerning, as it can lead to super-gonorrhea. (Note: Gonorrhea can infect genitals as well as the rectum and the throat).

“When you use antibiotics to treat infections like a normal sore throat, this mixes with the Neisseria species in your throat and this results in resistance,” Dr. Wi told the BBC. “In the US, resistance [to an antibiotic] came from men having sex with men because of pharyngeal infection.”

According to the WHO, an estimated 78 million people are infected with gonorrhea each year, many of whom go undiagnosed and untreated due to the lack of symptoms. Complications for the sexually transmitted disease disproportionally affect women, and when left untreated can lead to pelvic inflammatory disease, ectopic pregnancy and infertility and an increased risk of HIV.

As for those who do experience symptoms, which can range from thick green or yellow discharge from the urethra or the vagina to pain when urinating, WHO says many doctors often assume gonorrhea is the culprit for similar symptoms and prescribe antibiotics, even though the patient may be suffering from another kind of infection. It is this inappropriate use of antibiotics, as well as others, that increase resistance to the disease.

As a result of these findings, the WHO is calling for faster development of new drugs (three new candidate drugs are currently in various stages of clinical development), evaluations of existing antibiotics to treat resistant gonorrhea, easier-to-administer treatments, such as combination packages, and simplified guidelines.

“To control gonorrhea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures,” said Dr. Marc Sprenger, Director of Antimicrobial Resistance at the WHO. “Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests—ideally, ones that can predict which antibiotics will work on that particular infection—and longer term, a vaccine to prevent gonorrhea.”

In the meantime, the WHO encourages practising safe sex by using condoms consistently and correctly to prevent transmission of the STI.

 

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