"Stealth" Gonorrhea Strains on the Rise

A new study shows "a widespread dissemination among several countries" of strains of gonorrhea that lack an enzyme used to detect and diagnose the infection. The enzyme, prolyliminopeptidase, was previously thought to be found in all gonorrheal strains. Its absence can result in incorrect or delayed diagnosis, said Dr. Magnus Unemo of Sweden's Orebro University Hospital and colleagues.

Most of these prolyliminopeptidase-negative strains -- identified in Australia, New Zealand, and Scotland -- were identical or highly related to a strain previously detected in an outbreak in England and Denmark. The majority of these strains remain fully susceptible to several antibiotics used to treat gonorrhea infection, the researchers noted.

Increased awareness of prolyliminopeptidase-negative strains is "crucial," and changes in diagnostic methods may be needed in several geographic areas, the authors concluded. "For example, the use of at least two different assays" which are based on different principles, is fundamental."

The study, "Global Transmission of Prolyliminiopeptidase-Negative Neisseria Gonorrhoeae Strains: Implications for Changes in Diagnostic Strategies," was published in Sexually Transmitted Infections (2007;83:47-51).

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