Emergence of the gonorrhoea “superbug”

Two issues discussed at the recent ISSTDR (International Society Sexually Transmitted Diseases Research) for Conference (11th-14th July) in Montreal, Canada, have made the headlines.

First, the emergence in Japan of a new drug resistant “superbug” – an apparently untreatable strain of Gonorrhea (H041). Dr Magnus Unemo of the Swedish Reference Laboratory for Pathogenic Neisseria reported on his work with Japanese colleagues to characterize the new strain which has proved resistant to all the current frontline drugs, including cephalosporins. This development is “alarming”, since cephalosporins are the last line of defence; but also “predictable”, given that gonorrhoea has progressively developed resistance to all the drugs used against it – first, to penicillin and tetracycline, and subsequently, since the early 80s, to fluoroquinolines. At present CDC (the US Centers for Disease Control and Prevention) recommends treatment with a cephalosporin and either azithromycin or doxycycline. Dr Unemo’s statement follows just three days after a recent report emanating from the CDC that US gonorrhea was proving increasingly less susceptible to frontline drugs, including cephalosporins.

Traditionally, southeast Asia has developed resistant isolates, which have subsequently spread across the Pacific to the US. The new strain seems to be capable of passing its resistance quickly when grown in culture with other strains, increasing their resistance 500-fold. The upshot is that we can expect gonorrhoea to become progressively harder to treat over the next five years, unless new drugs are developed. Prevention will increasingly remain the only strategy.

ISSTDR abstracts to be found in:

Sexually Transmitted Infections, July 2011, vol. 87, suppl. 1: 19th Biennial Conference of the International Society for Sexually Transmitted Diseases Research
http://sti.bmj.com/content/87/Suppl_1.toc

Laura Blue, Time, Scientists Discover Drug-Resistant Gonorrhea “Superbug”, 11 July, 2011
Scientists Discover Drug-Resistant Gonorrhea ‘Superbug’

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