Gonorrhea is more dangerous than ever as resistance to antibiotics grows

U.S. health officials have identified a cluster of gonorrhea infections that show sharply increased resistance to the last effective treatment available for the country’s second most commonly reported infectious disease.

The findings from a cluster of Hawaii cases, presented Wednesday at a conference on prevention of sexually transmitted diseases, represent the first cluster of cases in the United States that have shown such decreased susceptibility to the double-antibiotic combination used when other drugs have failed. If the bacteria continue to develop resistance, that end-of-the-line therapy ultimately will fail, and an estimated 800,000 Americans a year could face untreatable gonorrhea and the serious health problems it causes, health officials said.

This latest news about antibiotic resistance came as world leaders gathered at an unusual meeting at the United Nations to address the rising threat posed by superbugs, microbes that can’t be stopped with drugs. Leaders adopted a joint declaration committing them to address the root causes of antimicrobial resistance, especially in human health, animal health and agriculture.

In the United States, drug-resistant gonorrhea already is one of the country’s three most urgent superbug threats, according to the Centers for Disease Control and Prevention. In each case, as with other diseases such as pneumonia and tuberculosis, overexposure to antibiotics has allowed the particular germ to more rapidly develop resistance.

CDC warned this summer that evidence of gonorrhea’s diminished vulnerability to one of the last-resort drugs, azithromycin, was emerging nationwide. But it said the other antibiotic, ceftriaxone, was still effective.

That’s why the latest findings are so distressing for health officials. It means current treatment options are in jeopardy, said Gail Bolan, director of CDC’s division of STD prevention. “What’s unique about this cluster now identified in Hawaii is that these strains we’ve really never seen before,” she said.

Many people don’t actually know they’re infected with gonorrhea because they have no symptoms. As a result, the disease goes undetected and untreated, which can cause a range of problems. Women risk chronic pelvic pain, life-threatening ectopic pregnancy and even infertility. And for both women and men, infection also increases the risk of contracting and transmitting HIV.

At a fundamental level, antimicrobial resistance is a public health failure, some experts said. Governments need to accept that responsibility, stressed Joanne Liu, international president of Doctors Without Borders, which is known by its French acronym, MSF. “I am running out of options,” she said. Too often, MSF doctors are treating children injured by war wounds, who “end up dying from a bone infection weeks later,” she said.