On the same day the United Nations launched a new plan to try and help stem the rapidly developing problem of antibiotic resistance around the world, the US Centers for Disease Control (CDC) also announced that they have identified a new “super” gonorrhea on the brink of becoming resistant to all known antibiotics used to treat it.
Over the last few years, the bacterium that causes gonorrhea, Neisseria gonorrhoeae, has become resistant to more and more antibiotics, until only two are now left that can effectively treat the infection. It was only last year that evidence started to emerge that the bacteria was starting to build and spread resistance to the first of these, azithromycin, all across the US. Now, the CDC has reported that a strain of gonorrhea has been identified that is not only resistant to azithromycin, but also has reduced susceptibility to the second one, ceftriaxone.
Detected in seven patients infected with gonorrhea in Hawaii in April and May of this year, this is the first cluster of cases becoming more unresponsive to both remaining drugs, and is a warning of what the future could hold if it manages to spread. “Our last line of defense against gonorrhea is weakening,” said Jonathan Mermin, the director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “If resistance continues to increase and spread, current treatment will ultimately fail and 800,000 Americans a year will be at risk for untreatable gonorrhea.”
The current advice from the CDC is for patients diagnosed with the infection to take a single shot of ceftriaxone and one oral dose of azithromycin, as they are the final drugs able to counter the bacteria. The seven cases from Hawaii were treated successfully using this regime, but the emergence of a bacteria that is becoming less responsive to these antibiotics is an urgent precursor to the fact that it may soon become completely resistant to both. The fact that all the patients reported were in a cluster is also of concern, as it suggests that the strain is able to spread.
In the past, when gonorrhea showed signs of building resistance to one class of antibiotics, the CDC would recommend switching to another, but clearly that can no longer happen, meaning that new treatments are in urgent need of development. Thankfully, there is one on the horizon. ETX0914 has already been tested in randomized controlled trials and is proving effective as an alternative, working in a different way to the standard drugs. Yet this is still thought to be years away from market, with the CDC now pushing for more rapid development.