February 15, 2012
Gonorrhea is increasingly showing resistance to one of the last known effective antibiotic treatments, and researchers say it is time to "sound the alarm" about the potential for untreatable forms of the STD.
"During the past three years, the wily gonococcus has become less susceptible to our last line of antimicrobial defense, threatening our ability to cure gonorrhea," Dr. Gail Bolan, director of CDC's STD prevention program, and colleagues wrote in a perspective piece.
Gonorrhea has had a long history of developing resistance to antibiotics, CDC notes, but more effective drugs have usually been available to treat patients. However, today about 1.7 percent of gonorrhea cases are resistant to cephalosporins, the last line of defense against the STD. That is a 17-fold increase in such resistance since 2006, when surveillance data showed the prevalence of resistance was 0.1 percent.
The strains have been appearing most often in western states, where 3.6 percent are showing resistance to cephalosporins, and in men who have sex with men, with nearly 5 percent showing resistance, said Bolan. In the United States, it is estimated there are more than 600,000 incident cases of gonorrhea annually.
It is by using a combination of cephalosporins and other antibiotics that U.S. doctors have been able to prevent gonorrhea infections from being completely untreatable, CDC spokesperson Nikki Mayes wrote in an e-mail. However, "The trends in decreased susceptibility that we're seeing, coupled with the history of emerging resistance and reported treatment failures in other countries, point to the likelihood of treatment failures on the horizon," she said.
"As far as gonorrhea goes, I am not aware of any new drugs in the pipeline," said Nicole Mahoney, senior officer of the antibiotics and innovation project at PEW Charitable Trusts. While a gonorrhea vaccine "remains key to prevention and control," it is a "distant goal," Bolan noted.
The article, "The Emerging Threat of Untreatable Gonococcal Infection," was published in the New England Journal of Medicine (2012;366(6):485-487).