First cases of 'incurable' antibiotic resistant gonorrhea found in North America as CDC warns of public health nightmare

The long feared nightmare of U.S. public health officials has come to pass with the news anti-biotic resistant Gonorrhea has been detected in North American patients.



A study released today by the Journal of the American Medical Association announced it had found nine patients with a strain of the sexually transmitted disease immune to the last remaining effective oral antibiotic.



This confirms the fears of both the Centers for Disease Control and the World Health Organisation who warned last year that untreatable gonorrhea, the world's second most common STD would soon become a reality.

Neisseria gonorrhoeae is the bacteria that causes the sexually transmitted disease gonorrhea - scientists in North America noted in a study released on January 8th that they have detected the first incurable strain of the disease

'These are the clinical cases we've been waiting for,' said study leader Vanessa Allen of pUblic Health Ontario.



'This is the translation of the lab information into what the clinical consequence is.'

Researchers observed that 6.7 percent of patients with gonorrhea at one Toronto clinic still had the disease after a round of cephalosporins, which is the last antibiotic which doctors are able to use to cure the disease.



Out of 133 patients who returned for a 'test of cure' visit, nine remained positive with the disease, which is roughly one in 15 people. This study revealed the first time that cephalosporin-resistant gonorrhea had been found in humans in North America.

Cephalexin is the standard oral treatment for gonorrhea and now cases of the disease that show immunity to it have been detected in North America for the first time

In the past studies have noted only individual case reports of untreatable gonorrhea cases in the UK, Austria, France, Norway and Japan.



Adding to the growing fears of health officials in the U.S., Robert Kirkcaldy of the CDC writes in an editorial that the disease is becoming a threatening disease.



'Cephalosporin treatment failures have now been documented in North America,' writes Kirkcaldy.



'Although this milestone was expected, its arrival is deeply troubling.'



In each year, gonorrhea infects near to 700,000 Americans each year - producing symptoms such as painful urination, abdominal pain, genital discharge, itching and infertility in women.



Women who contract both HIV and gonorrhea are more likely to pass HIV onto their children than women with only HIV.



Just one year ago, Gail Bolan, director of the CDC's sexually transmitted disease prevention program said that the 'threat of untreatable gonorrhea is emerging rapidly.'



At the time of her comments, only 1.7 percent of test cultures of the disease were condsidered immune in laboratory environments.



Vanessa Allen said it proves how fast antibiotic resistance is evolving in disease.



'Out results aren't generalizable to the overall concentration because they all came from one clinic,' said Allen.



'But basically, the problem appears worse than we originally thought.'

The CDC warned last year about the dangers of poor sexual health and its implications on the spread of gonorrhea and now their nightmare seems to be becoming a reality

Despite the fact that the nine patients in Canada were cured with the injectable antibiotic known as ceftriaxone, Allen said she has noted a worrying 'parallel increase' in resistance to that antibiotic.



'I think without a doubt this will become a bigger problem,' said Allen.



'The next threat is when, not if, the same thing happens with ceftriaxone. And then what?'



In light of growing drug-resistance worldwide, the U.S. Centers for Disease Control and Prevention (CDC) recently recommended clinicians no longer prescribe a single antibiotic treatment.



Instead, they now advise that patients receive an injection of ceftriaxone as well as a week-long course of oral azithromycin or doxycycline.



'Clinicians must remain vigilant for cephalosporin treatment failures and report suspected cases to the local or state health department,' wrote Kirkcaldy.



'Patients with persistent or recurrent symptoms shortly after treatment should be retested for gonorrhea by culture.'



