Brain and Body

Gonorrhea May Become Untreatable, CDC Warns

July 15, 2016 | Kelly Tatera

Neisseria gonorrhoeae
Photo credit: Centers for Disease Control and Prevention

The bacteria is becoming resistant to the only two drugs left that treat the STD. 

According to the Centers for Disease Control and Prevention (CDC), the sexually transmitted disease gonorrhea is the second most commonly reported notifiable disease in the United States — over 350,000 cases were reported in 2014.

Infections caused by Neisseria gonorrhoeae can cause a pelvic inflammatory disease in women, which can lead to a number of serious reproductive problems, like infertility and chronic pelvic pain. The health risks can also be passed down to offspring, with the potential an eye infection that could be vision-threatening.

Some people who contract gonorrhea show no symptoms, while others may notice pain, burning, or discharge in the site of infection — typically the uterus, penis, anus, throat, or mouth.

There are two antibiotics used to treat the STD: azithromycin and ceftriaxone. Unfortunately, these two drugs might not measure up to the rapidly mutating bug, which is evolving to resist the antibiotic treatments.

“The potential for untreatable gonorrhea is a very real possibility in the future,” first author of the report, Dr. Robert Kirkcaldy, said in an interview with STAT.

In a new report, the CDC says a nationwide surveillance program uncovered increases in the percentage of gonorrhea samples that were resistant to one drug or the other, and in the case of azithromycin, the rise in resistant samples was four-fold in 2014 alone.

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Before panicking, the researchers say that the rates are still modest. With azithromycin, the percentage of resistant samples went from 0.6 percent to 2.5 percent, and with ceftriaxone, the rates doubled from 0.4 percent to 0.8 percent.

“It is low. But what we do know is that this bacteria has demonstrated the ability, repeatedly, to develop antibiotic resistance to the drugs that have been used for it,” Kirkcaldy noted.  

The good news is that N. gonorrhoeae strains that were resistant to either azithromycin or ceftriaxone were still susceptible to the other drug, and thus curable. But nonetheless, "We think ... it's a matter of when and not if with resistance," Kirkcaldy said. "This bug is so smart and can mutate so rapidly."

Plus, once the bacteria are resistant to a drug, they don’t appear to lose that resistance. Kirkcaldy says that N. gonorrhoeae is still invulnerable to antibiotics that haven’t been used to treat the STD in decades.

The problem has also been observed outside of the US. Dr. Vanessa Allen, the chief medical microbiologist for Public Health Ontario, says that Ontario is also seeing rates of antibiotic resistance similar to what the CDC has found, according to STAT.

Kirkcaldy stayed away from predicting how quickly the bacteria may grow resistant to the two drugs, but says that combination therapy should buy more time.

Although some companies are working to develop new antibiotics, Kirkcaldy says they could be years away. So in the meantime, he stresses the importance of getting people to start taking the threat seriously, and take the appropriate measures to protect themselves from gonorrhea infection.

“The trend is known,” said Allen. “At some point, it’s just: How much can we slow it down?”

"It will happen and we don't have any other options,” he concluded.

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