Super-gonorrhea is here.

I have discussed a number of bacteria that are becoming increasingly resistant to antibiotics: KPC Klebsiella, and ANY bacteria containing the NDM-1 superplasmid. We also have known about increasing antibiotic resistance in the STD bacteria, Neisseria gonorrheae.

Historically (meaning since the first use of penicillin in1941), N. gonorrheae was easily treated with penicillin. However, it has demonstrated that it is not a bug to be trifled with.  It became resistant to penicillin, then to tetracycline, then to ciprofloxacin (Cipro).  Treatment became limited to third generation cephalosporins, ceftriaxone and cefixime. The CDC has a website documenting that once resistance to cephalosporins occurs, we will have little if any treatment available for this infection.

Therefore, today’s report out about a new strain of N. gonorrheae (identified as H041) that has developed resistance to all known antibiotics should be an expected event.

When cipro-resistant N. gonorrhea first emerged in the Far East in 1992, it quickly spread to Hawaii, and then to the west-coast of mainland US by the late 1990’s. As of 2007, the CDC stopped recommending cipro for treatment of N. gonorrheae. We can use the same timeline to guesstimate how long we have before MOST N. gonorrheae is completely untreatable.

Maryn McKenna, a blogger for Wired and a writer for Scientific American,  has been tracking these changes and she blames the increase in resistance to the use of rapid tests for STDs. She argues these tests identify an organism that is causing disease, but not it’s ability to resistance treatment. So the problem shifts to the quick prescription fix that most doctors in the U.S. use to treat a common infection: ” Here is a dose of cipro, if that doesn’t clear the infection up we will try another”.  All that has done is to allow the patient with the infection to continue to spread the bug until the right antibiotic can be determined. She has a very valid hypothesis.

Sadly, the other problem with N. gonorrheae is that about 50% of infections in women are asymptomatic. Young girls experimenting with sex, could easily get the infection and never know it. Infections with N. gonorrheae do not cause long lasting immunity and recurrent infections lead to something called pelvic inflammatory disease (PID), which leads to infertility. The Vancouver Sun published a study on rising rates of infertility in couples trying to conceive.

So, let’s go back to history. Penicillin was first mass produced in 1941 by Florey, Chain and Heatley. In less than 70 years, a little gram-negative diplococci has learned to completely evade all antibiotics developed since then, and we are back to where we were in 1940. Some progress, huh?

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