Gonorrhoea becoming untreatable due to antibiotic resistance
Gonorrhoea is becoming impossible to treat as it has evolved to resist antibiotics, the World Health Organisation (WHO) has warned.
Data from 77 different countries showed that the gonorrhoea-causing bacteria are becoming increasingly resistant to older and cheaper antibiotics.
In some countries, particularly high-income ones were surveillance is better, scientists are finding cases of gonorrhoea that are resistant to all types of antibiotics.
Dr Teodora Wi, a medical officer at WHO, said the bacteria causing gonorrhoea are “particularly smart”.
“Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them,” she said.
“These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common.”
Speaking to the BBC at a press conference, Dr Wi added that it was gonorrhoea in the throat that was particularly concerning.
When antibiotics are used to treat infections like a typical sore throat, this mixes with the Neisseria species of bacteria, of which gonorrhoea is a member, and results in resistance if someone then goes on to contract gonorrhoea orally.
It is estimated that 78 million people globally are infected with gonorrhoea each year, in the genitals, rectum, or throat.
Complications seen occurring from infections typically affect women, with problems such as pelvic inflammatory disease, ectopic pregnancy and infertility being reported. The bug also increases your risk of HIV.
A WHO body monitoring the trends in drug-resistant gonorrhoea found widespread resistance to ciprofloxacin, and increasing resistance to azithromycin, along with an emergence of resistance to a treatment currently being used as a last resort, the extended-spectrum cephalosporins (ESCs) oral cefixime or injectable ceftriaxone.
In most parts of the world, ESCs are the only remaining treatment for treating gonorrhoea, but resistance to these has now been reported in more than 50 countries. Because of this, new WHO guidelines issued in 2016 advised doctors to give two antibiotics, ceftriaxone and azithromycin, at a time.
There are not many new drugs to treat the STI in development. In fact, developing new antibiotics is not particularly attractive to pharmaceutical companies as treatments are only for short periods of time, and, due to resistance developing, new drugs need to be replenished constantly.
Dr Manica Balasegaram of the Global Antibiotic Research and Development Partnership (GARDP) said that seizing opportunities with drugs currently in development was urgent.
“In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use,” she said.
“Any new treatment developed should be accessible to everyone who needs it, while ensuring it’s used appropriately, so that drug resistance is slowed as much as possible.”
Many people who contract gonorrhoea, which can be prevented by consistent and correct use of condoms, don’t present with any symptoms, so go undiagnosed and untreated.
However, if people do have symptoms, such as discharge, doctors often presume it is gonorrhoea and prescribe antibiotics, even though people may be suffering from another kind of infection. This increases the development of antibiotic resistance in gonorrhoea as well as other bacterial diseases.
According to Dr Marc Sprenger, director of antimicrobial resistance at WHO, new tools and systems are needed for better prevention, treatment, and tracking of infections.
“Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhoea,” he added.