Straight, No Chaser: STDs – Multidrug Resistant Gonorrhea

Gonorrhea threat

This post is the second of two discussing gonorrhea. Today we discuss multidrug resistant gonorrhea. That’s right. There are new strains of gonorrhea emerging and spreading, as if the existing strains weren’t devastating enough already.

The development of multidrug resistant gonorrhea has occurred. Gonorrhea has affected humans for centuries, and the organism causing it has been identified for over one hundred years. According to the Center for Disease Control and Prevention (CDC), there were over 468,500 cases of gonorrhea in the U.S. alone in 2016. That represents an increase of 48.6% since the record low in 2009. (On a tangential note, this represents another significant cause of health care disparities; Blacks are 17 times more likely to be affected that Whites. This isn’t just due to behavioral patterns. In fact, it’s largely due to the asymptomatic nature of gonorrhea and the relative lack of access to care among Blacks, impacting ability to get treated).

Gonorrhea has proven itself to be especially wily. We’ve had access to effective antibiotics against it since the 1930s. Still, it continues to plague us. In the 1940s, the 1970s, and again in the 1990s, gonorrhea mutated and developed immunity to treatments that had been effective. In addition most cases of gonorrhea don’t cause symptoms, allowing itself to be spread in a “stealth” manner (Read: get checked).

 gonorrhea

Even more so than other instances of gonorrhea resistance, this instance poses especially concerning dangers. Treatment of multi-drug resistant gonorrhea infections (particularly those resistant to the standard of care medicine ceftriaxone) will be much more complicated that it had been previously. Specifically, there is no ready replacement on standby that can be administered in emergency rooms, offices and clinics as easily as a simple shot of ceftriaxone is. Our most recent magic bullet is going by the wayside. Other available treatments also have varying degrees of emerging resistance and thus are likely to be sporadically ineffective. Until on-site testing is put in place that allows determination of susceptibility to various treatment regimens, patients infected with gonorrhea will run the risk of receiving medicines that are no longer effective. Current and future treatment regimens will involve the use of more than one medicine and higher doses of medicine than had previously been effective.

 PHIL_3766

This brings to mind two important points. Gonorrhea is not just an infection that affects sexual organs. It produces devastating consequences throughout the body, including the facilitation of human immunodeficiency virus (HIV) transmission (i.e. the presence of gonorrhea makes acquiring HIV easier). It also causes serious reproductive complications in women, such as pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. It causes eye infections in newborns (they pick it up from mom) and infected persons who rub their eyes or otherwise place their fingers in their eyes without appropriate hand washing. Either failure to get treated or receiving ineffective treatment is a precarious situation.

 condom

Of course, this also creates and reinforces the urgency of practicing safe sexual behaviors. Straight, No Chaser has multiple postings on safe sex and best practices of preventing sexually transmitted infections. Here is a summary post for your review. Of course you can type any topic in the search engine for greater ability to explore these topics.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

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Filed under Genital/Urinary, Infectious Disease, Obstetrics and Gynecology

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