Monday, July 11, 2011

Going, Going, Gonorrhea


Updated: Maryn McKenna has weighed in on this story as well this morning, with her Superbug blog

The Clap Came Back: Multi-Drug Resistant Gonorrhea



# 5685




Photo Credit  CDC- PHIL.



In a bit of a follow up to Saturday’s blog The Path Of Increased Resistance regarding last week’s MMWR on the rise of antibiotic resistant Neisseria gonorrhoeae, today the media is overrun with stories about a paper to be delivered later today at the International Society for Sexually Transmitted Diseases Research in Quebec City.


A few examples include:


Swedish researcher finds resistant gonorrhea


New gonorrhea strain alarms experts


Gonorrhea is now a superbug:  Antibiotic-resistant strain could turn STD into global public health threat, experts warn



The abstract to this paper may be found on page 76A of the ISSTDR abstract book (Free PDF) :




M Ohnishi,M Unemo,D Golparian,K Shimuta,T Saika, S Hoshina,K Iwasaku,S I Nakayama,J Kitawaki


While making a media splash today, the actual discovery of this resistant strain was made in 2009 in a 31 year-old female sex worker in Japan, and reported in the CDC’s EID journal  (Volume 17, Number 1–January 2011) as Ceftriaxone-Resistant Neisseria gonorrhoeae, Japan.


What is new today is the H041 strain has been extensively characterized, phenotypically and genetically, to confirm the initial findings and to provide more details on the mechanisms of resistance.


The bottom line, from the abstract, is that:


H041 proved highly resistant to ceftriaxone (2-4 mg/l, which is 4-8-fold higher than any previously described isolate) and all other cephalosporins, as well as most other antimicrobials tested.


The biological fitness and transmissibility of this resistant strain has yet to be determined, and it is unknown how much (if at all) it has spread over the past couple of years.


Resistant strains, however, have a history of eventually propagating. 


With 700,000 new cases in the United States, and millions globally each year, the stakes here are very high. Should a cephalosporin resistant strain begin to dominate, the treatment options today are very limited.  


Just as we’ve seen with MRSA, NDM-1, KPC and a host of other constantly evolving pathogens, unless we can develop new classes of effective antibiotics, our victories over them may prove short lived.