“Super Strain” of Gonorrhea Spreading Throughout the U.S.

The emergence of a so-called “super strain” of gonorrhea in the United States has raised alarm among health officials and experts, as many types of antibiotics have been found to be less effective or completely ineffective against this strain.

This marks the first case in the US where all recommended drugs were ineffective in treating the disease. The case, identified in Massachusetts, was successfully treated with ceftriaxone, an antibiotic recommended to treat the disease, state health officials said in a news release.

The newly identified strain showed reduced susceptibility to three types of antibiotics and resistance to an additional three, including penicillin. It marks the first U.S. case in which all recommended drugs were less effective or completely ineffective, the state health department said in a Thursday bulletin to clinicians.

This serves as “an important reminder that strains of gonorrhea in the U.S. are becoming less responsive to a limited arsenal of antibiotics,” health officials said in a statement.

The U.S. is experiencing “a rising epidemic of sexually transmitted disease,” Dr. Georges Benjamin, executive director of the American Public Health Association, said, with some experts referring to the issue as a “hidden epidemic.”

Cases of gonorrhea, an STD that often shows no signs, but can lead to genital discharge, burning during urination, sores, and rashes, among other symptoms, rose by 131% nationally between 2009 and 2021, according to public health officials. While rates of STD transmission in the U.S. fell during the early months of the pandemic, they surged later in the year, with cases of gonorrhea and syphilis eventually surpassing 2019 levels, according to the CDC.

Another similar strain of gonorrhea, with reduced response to ceftriaxone and another antibiotic, was also recently identified in Massachusetts, health officials noted.

And a similar case was recently seen in Nevada, though that strain remained sensitive to at least one type of antibiotic. The novel strain has been previously reported in Asia-Pacific countries and the United Kingdom in recent years, Massachusetts health officials said.

The emergence of this super strain of gonorrhea highlights the growing concern regarding antimicrobial resistance, one of the top 10 public health threats facing humanity, according to the World Health Organization. Antimicrobial resistance occurs when bacteria, viruses, fungi, and parasites evolve over time, becoming less responsive to medicines, making infections increasingly difficult, or impossible, to treat.

“We are watching this antibiotic era turn into a post-antibiotic era,” Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP), said. “That is a scary proposition.”

Global efforts are underway to slow the increase of resistance, since it’s an impossible process to stop, he says. But little is being done in this regard, or to develop new treatments. A November 2021 statement by the WHO called the clinical pipeline of new antimicrobials “dry.”

Two years later, that pipeline remains dry, according to Benjamin. As an increasing number of treatments become ineffective due to antimicrobial resistance, “we’re having to use ‘more powerful drugs’ with more side effects,” he says. “At some point, we won’t have anything useful to treat [gonorrhea] with.”

It wasn’t so long ago that “children died all the time from bacterial infections that today we wouldn’t think twice about—they’re easy to treat,” Osterholm said.

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