Drug-Resistant Gonorrhea Spreading

By Amir Khan on June 7, 2012 2:29 PM EDT

WHO
The World Health Organization's headquarters in Geneva (Photo: WHO)

Drug-resistant gonorrhea is spreading across the world, the United Nations warned on Wednesday.  Unless doctors catch and treat cases sooner, millions of patients may be stuck with an untreatable STD.

"Gonorrhoea is becoming a major public health challenge," Manjula Lusti-Narasimhan, from the WHO's department of reproductive health and research, told Reuters. "The organism is what we term a superbug - it has developed resistance to virtually every class of antibiotics that exists. If gonococcal infections become untreatable, the health implications are significant."

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The World Health Organization called for greater vigilance in the use of antibiotics. The emergence of drug-resistant bacteria stems from unregulated use of the drugs, which helps fuel mutations in the bacteria and makes them resistant.

Antibiotic resistant gonorrhea isn't a new problem. During World War II, gonorrhea became resistant to the drug sulfanilamide. In the 1980s, it became resistant to penicillin and tetracyclin. In 2007, the antibiotic fluoroquinolone stopped working. Now researchers worry that they are running out of effective drugs.

People with gonorrhea often do not exhibit symptoms, but possible symptoms are vaginal discharge, lower abdominal pain or pain during intercourse. Men can also experience a burning sensation during urination. If left untreated, serious health issues can develop, including pelvic inflammatory disease, which can lead to infertility in women and is one reason the antibiotic resistant strain can be a huge problem.

Gonorrhea is spread through vaginal, anal or oral intercourse and can be transmitted during childbirth. Contrary to popular belief, you cannot catch gonorrhea from a toilet seat.

But how do the bacteria that cause gonorrhea become resistant to antibiotics?

Antibiotics work by killing susceptible bacteria, but some microbes can survive because of an ability to neutralize or avoid an antibiotic. Resistant strains, either naturally or through mutations, survive, multiply and replace bacteria destroyed by antibiotics.

"Bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria," according to the CDC website. "The DNA that codes for resistance can be grouped in a single easily transferable package. This means that bacteria can become resistant to many antimicrobial agents because of the transfer of one piece of DNA."

The biggest contributor to bacteria drug resistance is the over-prescription of antibiotics, according to the CDC. Antibiotics are frequently prescribed for viruses, simply because healthcare providers think patients expect them. The common cold is the most common reason antibiotics are prescribed, despite the fact that antibiotics do not affect viruses.

It's unclear how widespread the drug resistance is because many countries lack reliable data, the WHO said.

"Without adequate surveillance we won't know the extent of resistance...and without research into new antimicrobial agents there could soon be no effective treatment for patients."

Researchers said the evolution of the gonorrhea is fascinating , saying that if an untreatable form wasn't so scary, it's be fun to study.

"They used to say that if you have urethral gonorrhoea you go to the toilet to pass urine, it would be like passing razor blades. It was that painful," Francis Ndowa, the WHO's former lead specialist for sexually transmitted infections, told Reuters.

"Now people with gonorrhoea sometimes...only notice the discharge if they look when they pass urine, it's not that painful anymore. So the organism has readjusted itself to provide fewer symptoms so that it can survive longer. It's an amazing interaction between man and pathogen."

The only 100 percent effective method of preventing gonorrhea, according to the CDC, is sexual abstinence, but proper usage of a latex condom and monogamous intercourse with a person known to be uninfected can dramatically reduce the risk.

"We're not going to be able to get rid of it completely," Lusti-Narasimhan told CBS News. "But we can limit the spread."

© 2012 iScience Times All rights reserved. Do not reproduce without permission.

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