June 28th, 2016
According to latest research reported in the Antimicrobial Agents and Chemotherapy journal (1) investigators suggested that the treatment of gonorrhea is becoming difficult with every passing day due to antibiotic resistance phenomena. In 2009, around 25% cases of this disease were found to be resistant against the most common treatment protocol (i.e. Tetracycline, Penicillin and Fluoroquinolones). Since then broad-spectrum Cephalosporin (cefixime and ceftriaxone) are the main-stay therapy for the first-line management of infection. What’s more alarming is that the data of year 2010 predicted that certain gonorrhea strains (such as H041) have developed resistance against Cephalosporin in Japan and F89 resistance cases were reported in France.
Gonorrhea is regarded as the most frequently reported sexually transmitted infection in the United States. According to latest statistics reported by Centers for Disease Control and Prevention (2), investigators suggested that it is more common in males as compared to females (i.e. 120 cases per 100,000 vs. 101 cases per 100,000 in females). The highest number of gonorrhea cases are reported in young males (age range 20-29 years).
The classic symptoms of this disease in men are:
In some cases, there may be no symptoms for days or weeks, which may delay the diagnosis/ management.
Dr. Kimberly Workowski (the Organizer and Coordinator at CDC Sexually Transmitted Diseases Guidelines Panel), while talking to a news source about increasing risk of resistance against antibiotics said, “This may be the harbinger of things to come. The resistance may be getting worse.”
The infection of this disease is showing resistance against antibiotics since 1970s, but things are becoming worse than before. Although, at the moment cephalosporin resistance is prevailing in South East Asia but chances are that very soon it will cover the entire globe at some point if heroic measures are not sought.
Despite the fact that gonorrhea remains asymptomatic in most subjects, it can lead to very serious health conditions in poorly managed cases; such as infertility in women, chronic pain in pelvic region and ectopic pregnancies
In men, poorly managed gonorrhea can lead to epididymitis. If it is not treated properly it may disseminates into blood; thereby aggravating the risk of sudden death due to septicemia
Fortunately, investigators are exploring ways to overcome resistance against gonorrhea and other sexually transmitted diseases. For example:
1. Ohnishi, M., Golparian, D., Shimuta, K., Saika, T., Hoshina, S., Iwasaku, K., … & Unemo, M. (2011). Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrobial agents and chemotherapy, 55(7), 3538-3545.
3. Centers for Disease Control and Prevention (CDC. (2004). Increases in fluoroquinolone-resistant Neisseria gonorrhoeae among men who have sex with men–United States, 2003, and revised recommendations for gonorrhea treatment, 2004. MMWR. Morbidity and mortality weekly report, 53(16), 335.
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