Colorized scanning electron micrograph of the Neisseria gonorrhoeae bacterium that causes gonorrhea.
The most drug-resistant gonorrhea cases ever detected in the United States were in two unrelated people in Massachusetts, state health officials said Thursday.
This case is the first time the causative agent of gonorrhea has been isolated in the United States. Neisseria gonorrhoeaeindicating complete tolerance or reduced sensitivity to all drugs recommended for treatment.
Fortunately, a strong injection of the antibiotic ceftriaxone successfully cured both cases, although the bacterial isolates showed reduced susceptibility to the drug. Ceftriaxone is now the frontline recommended treatment for sexually transmitted infections.
But health officials said these cases were a warning. “Neisseria gonorrhoeae They are blunting their response to the limited arsenal of antibiotics,” they said.
brew resistance
For years, global surveillance data collected by the World Health Organization has shown that gonorrhea is becoming increasingly resistant to a full line of drugs, including front-line drugs like ceftriaxone. Surveillance is spotty globally, but a study of WHO 2017–2018 data published in 2021 found: Neisseria gonorrhoeae Isolates with reduced susceptibility or resistance to ceftriaxone were detected in 21 of the 68 reported countries, or 31%.
Resistance to alternative antibiotics was even higher. Of the 61 countries reporting data on the alternative antibiotic azithromycin, 51 (84%) reported resistance. And of the 51 countries reporting data on the alternative antibiotic treatment cefixime, 24 (47%) report resistance. Ciprofloxacin is an antibiotic largely abandoned for the treatment of gonorrhea due to resistance, with resistance found in all 70 countries where it has been reported.
“In many countries, ciprofloxacin resistance is very high, azithromycin resistance is increasing rapidly, and resistance or reduced susceptibility to ceftriaxone and cefixime continues to emerge,” WHO said in 2021. Stated. It will be difficult to treat and cure. “
The agency was not exaggerating. Last year, the WHO added that reports of gonorrhea treatment failures were mounting. Failure to cure gonorrhea with concomitant use with azithromycin or doxycylin was confirmed,” reported WHO.
One of the isolates reported yesterday in Massachusetts showed reduced susceptibility to ceftriaxone, cefixime, and azithromycin, and laboratory resistance to ciprofloxacin, penicillins, and tetracyclines. A second isolate appeared to have a similar profile based on genetic data, Massachusetts Public Health Service reported.of this strain Neisseria gonorrhoeae It has been confirmed to be endemic in Asia-Pacific countries and has been detected in recent cases in the UK.
high case
Alongside the worrying trend of increasing resistance is the fact that gonorrhea cases are high worldwide and increasing in the United States. I’m assuming it did. In the United States, in 2021, he will have nearly 700,000 cases, up more than 25% from 2017, according to preliminary estimates from the U.S. Centers for Disease Control and Prevention.
In many people, gonorrhea is asymptomatic. In others, it is mild enough that it can be mistaken for a mild bladder or yeast infection. But over time, it can lead to pelvic inflammatory disease, severe pain, and infertility. Health officials stress the need for screening and surveillance to treat infections early before they become severe and spread.
Health officials are currently working on contact tracing for two cases in Massachusetts. There is no clear link between the two cases, but officials say it is likely more widespread than currently known.
“The discovery of this strain of gonorrhea is of serious public health concern, and the DPH, CDC, and other health departments are paying attention to the discovery in the United States,” Massachusetts Public Health Commissioner Margret Cook said in a statement. “We urge all sexually active people to get tested regularly for STIs, reduce the number of sexual partners, and consider increasing the use of condoms when having sex. Clinicians are encouraged to review clinical alerts and cooperate in expanding surveillance efforts.”
