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Antibiotic-Resistant Gonorrhea Arrives in North America

Andy Towle January 9, 2013

Gonorrhea resistant to antibiotics has been reported for some time. What you should be concerned about is that it has now arrived in North America:

GonorrheaIn a study released Tuesday in the Journal of the American Medical Association, a group of scientists led by Vanessa Allen of Public Health Ontario, found that 6.7 percent of patients with gonorrhea at a Toronto clinic still had the disease after a round of cephalosporins, the last effective oral antibiotic used to treat the disease. Of 133 patients who returned for a "test of cure" visit, nine remained gonorrhea-positive. This is the first time cephalosporin-resistant gonorrhea has been found in humans in North America.

"These are the clinical cases we've been waiting for," Allen says. "This is the translation of the lab information into what the clinical consequence is."

The report:

In an accompanying editorial, Robert D. Kirkcaldy, M.D., M.P.H., of the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, and colleagues write that the findings of this study, of documented cephalosporin treatment failures in North America, although expected, “its arrival is deeply troubling; clinicians now face the emergence of cephalosporin-resistant N gonorrhoeae without any well-studied, effective backup treatment options.”

“New antibiotics for treating gonococcal infections are needed. A clinical trial sponsored by the National Institute of Allergy and Infectious Diseases examining novel combinations of existing drugs just completed enrollment, and a small study of a new oral agent is ongoing. But the antibiotic pipeline is running dry: continued investment in antibiotic development is critical. Meanwhile, the gonococcus has continued to develop the capability to defeat each new antibiotic used. The threat of drug-resistant gonorrhea is increasing and has reached North America. Clinicians, drug developers, and public health professionals must act now.”

UPDATE: A better article from NPR notes that the gonorrhea can be eventually cured at this stage:

…even in the Canadian study, all patients eventually recovered when they were given larger doses of cefixime or a related antibiotic. Nevertheless, there have been worrying signs of antibiotic-resistant gonorrhea in the U.S.

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