by A tribe of gonorrhea that is resistant to several classes of antibiotics recently infected two people in Massachusetts, the state Department of Public Health announced (opens in a new tab) Thursday (January 19). This is the first time that “resistance or reduced response to five classes of antibiotics has been identified in gonorrhea in the United States,” the department reported.
Gonorrhea is a common sexually transmitted infection caused by bacteria Neisseria gonorrhoeae. Over time, the bacterium has grown resistant to most things antibiotics historically used to kill it, and it Centers for Disease Control and Prevention (opens in a new tab) (CDC) says “it’s only a matter of time” before it becomes resistant to the only treatment currently recommended, an antibiotic called ceftriaxone. (Under special circumstances (opens in a new tab)other antibiotics may still be used instead of ceftriaxone, but they are not widely recommended.)
Sexually transmitted disease (STD) clinics across the United States regularly monitor for resistant strains of N. gonorrhoeae by testing the insects’ response to seven different antibiotics; these include medicines currently and in the past used to treat gonorrhea. In one of the Massachusetts residents, officials discovered a strain resistant to three of those drugs and showing a “reduced sensitivity” to three others, including ceftriaxone, they reported in a notification (opens in a new tab) to clinicians. Bugs with “reduced sensitivity” do not yet have full resistance to a drug, but are less sensitive to the treatment than normal.
The officials later identified a second N. gonorrhoeae sample from another person likely to show the same resistance and, in particular, a correspondingly reduced response to ceftriaxone; that conclusion was based on a genetic analysis of the strain. “No direct link” between the two gonorrhea cases has been identified, the department noted.
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Although the strain showed some resistance to ceftriaxone, both patients were cured with the recommended dose of antibiotics. This result “reinforces the CDC’s recommendation to use high doses of the antibiotic ceftriaxone to treat all gonorrhea cases and to perform follow-up testing to ensure that all patients with gonorrhea are successfully treated,” the health department said.
However, the cases still raise concerns because this is the first N. gonorrhoeae strain detected in the United States that shows resistance or reduced susceptibility to six of the seven antibiotics that are regularly screened, That was reported by CBS (opens in a new tab).
The Massachusetts Department of Public Health is now investigating whether others in the state have had the same strain. To do this, the department conducts contact tracing and works with the CDC and local health centers to collect and analyze additional N. gonorrhoeae samples.
“The identification of this strain, the same as that recently reported in the UK and previously reported as circulating in the Asia-Pacific countries, is a warning that N. gonorrhoeae becomes less responsive to a limited arsenal of antibiotics,” the department’s notice said.
“The concern is that this particular strain has been circulating around the world, so it was only a matter of time before it would hit the United States,” Dr. Jeffrey Klausner (opens in a new tab)said a clinical professor of public health at the University of Southern California’s Keck School of Medicine in Los Angeles. CNN (opens in a new tab). “We haven’t had new antibiotics to treat gonorrhea in years, and we really need a different treatment strategy.”
