Antibiotic-resistant Gonorrhea Hits North America
CDC calls potential threat a 'public health nightmare'  

Canadian doctors have detected an antibiotic-resistant strain of gonorrhea, marking the first time a drug-resistant strain of the disease has turned up in North America. Health officials warn that drug resistance means gonorrhea, already the second most common sexually transmitted disease, will only become more widespread and more difficult to treat.

 

Antibiotic-resistant gonorrhea had been detected previously in Europe and Asia, and so far, no drug-resistant cases have been reported in the U.S. But officials at the U.S. Centers for Disease Control and Prevention (CDC) said antibiotic-resistant gonorrhea could quickly turn into a "public health nightmare," potentially causing six million additional cases in the next seven years.

 

In a study published in the Journal of the American Medical Association this month, researchers studied patients with gonorrhea at a Toronto clinic to see how they responded to standard antibiotic treatments. The researchers found that infections in nine patients, almost 7 percent of the 133 patients in the study, failed to respond to cefixime, which is the last commercially available oral drug for gonorrhea. Antibiotics are considered ineffective when the failure rate exceeds five percent.

 

After the Canadian study's publication, the CDC urged health care providers to stop prescribing cefixime, marketed under the brand name Suprax, to treat gonorrhea. That leaves only one treatment option for gonorrhea: a combination of ceftriaxone, an injectable antibiotic and another oral drug.

 

Cefixime is one drug in a class of antibiotics known as cephalosporins, which was for decades the cornerstone of treatment for gonorrhea. The disease has become progressively more resistant to these and other drugs, including penicillin, tetracycline and sulfonamides.

 

According to the Georgia Department of Public Health's (DPH) STD Office, antibiotic-resistant gonorrhea would be bad news for the state. Georgia ranks sixth in the nation in numbers of reported gonorrhea cases; in 2011, 15,668 cases were reported in the state. Almost 65 percent of those cases occurred in adolescents and young adults between ages 15 and 24. The CDC estimates that about 700,000 Americans get gonorrhea each year, and only about half of those cases are reported.

 

If left untreated, gonorrhea can cause pelvic inflammatory disease (PID) in women and can affect fertility in both men and women. The disease also can increase a person's risk of contracting HIV.

 

Gonorrhea is just one example of the growing problem of antibiotic resistance, which the CDC warns is one of the world's most pressing public health threats. Michelle Allen, Georgia STD surveillance director, said public health officials, scientists and health care providers must work to keep this problem in check.

 

"We need to ensure that patients are given clear instructions on how to take antibiotics, that research continues to develop new antibiotics and that providers are aware of the resistance pattern in the communities they serve," Allen said.

 

When antibiotics are used inappropriately, bacteria learn to adapt to the drugs instead of being killed by them. That resistance can be deadly for humans and costly for the health care system, as infections that once responded to a simple antibiotic require more drugs and intensive medical care. In August, the CDC estimated that drug-resistant gonorrhea could lead to 800 new HIV infections, 250,000 new cases of PID and more than $750 million in lifetime medical costs.
 

-Story by Carrie Gann, DPH Communications 

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