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a strain of gonorrhea that is resistant to multiple 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 the bacterium Neisseria gonorrhoeae. Over time, the bacteria have become resistant to most antibiotics historically used to kill him, and the Centers for Disease Control and Prevention (opens in a new tab) (CDC) states that “it is only a matter of time” until it becomes resistant to the only currently recommended treatment, an antibiotic called ceftriaxone. (In specific circumstances (opens in a new tab)other antibiotics can still be used instead of ceftriaxone, but are not widely recommended).
Sexually transmitted disease (STD) clinics in the US regularly monitor for resistant strains of N. gonorrhoeae testing the response of insects to seven different antibiotics; these include drugs currently and previously used to treat gonorrhea. In one of the Massachusetts residents, officials detected a strain that is resistant to three of those drugs and shows “reduced susceptibility” to three others, including ceftriaxone, they reported in a alert (opens in a new tab) to clinicians. Insects with “reduced susceptibility” do not yet have full resistance to a drug, but are less sensitive to treatment than normal.
Officials later identified a second N. gonorrhoeae sample from a different person likely to show the same resistance and, in particular, a similarly reduced response to ceftriaxone; that conclusion was based on a genetic analysis of the strain. “No direct connection” has been identified between the two gonorrhea cases, the department said.
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Although the strain showed some resilience against ceftriaxone, both patients were successfully cured with the recommended dose of the antibiotic. This result “reinforces the CDC’s recommendation to use high doses of the antibiotic ceftriaxone to treat all cases of gonorrhea and to conduct follow-up testing to ensure that all gonorrhea patients receive successful treatment,” the health department stated.
However, the cases still raise concern because this is the first N. gonorrhoeae strain detected in the US showing resistance or reduced susceptibility to six of seven regularly tested antibiotics, CBS reported (opens in a new tab).
The Massachusetts Department of Public Health is now investigating whether others in the state have contracted the same strain. To do so, the department is doing contact tracing and working with the CDC and local health care facilities to collect and analyze additional information. N. gonorrhoeae samples
“The identification of this strain, like what has been recently reported in the UK and previously reported to be circulating in Asia-Pacific countries, is a warning that N. gonorrhoeae is becoming less sensitive to a limited arsenal of antibiotics,” the department’s alert reads.
“The concern is that this particular strain has been circulating around the world, so it was only a matter of time before it hit the US.” Dr. Jeffrey Klausner (opens in a new tab)clinical professor of public health at the University of Southern California Keck School of Medicine in Los Angeles, said CNN (opens in a new tab). “We haven’t had new antibiotics to treat gonorrhea for years and we really need a different treatment strategy.”
