April 26, 2007

Gonorrhea Strain Proves Resistant

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Recently the Center for Disease Control and Prevention discovered a drug-resistant strain of gonorrhea, previously considered a curable STD that was relatively easy to treat.
The new strain is immune to the fluoroquinolone antibiotic in the form of a pill that doctors have readily prescribed for over a decade. From now on, the only guaranteed treatment for all cases is a shot of the cephalosporin antibiotic.
“The problem is that gonorrhea is now an infection for which only one antibiotic will work,” said Dr. Alexandra Hall of Gannett. Hall said that people allergic to the shot have no options in terms of antibiotics, and doctors will have to grow strains of the individual’s resistant bacteria to pursue further testing and treatment options.
Gannett stopped using the pill form of the antibiotic a few years ago when signs of its resistance first appeared.
“By 2002, the CDC was already talking about strains resistant to the pill form. These resistant strains appeared throughout Asia and the West coast; since we have a large international population here at Cornell, we don’t use that form of the antibiotic,” Hall said.
According to a report by the World Health Organization conducted in 2000, widespread resistance to the penicillin-based group of antibiotics was confirmed in many Asian countries. The report, which monitored 11,000 cases, states that “options for cheap and effective treatment of gonorrhea in the Western Pacific Region are increasingly limited.”
This situation has worsened in recent years and spread to the United States and Canada.
The CDC estimates that over 700,000 people are infected with gonorrhea each year. At Cornell, however, the numbers are significantly less threatening.
“The disease is not very common on campus; of the tests we do for gonorrhea here at Gannett only 0.1 percent are positive,” said Hall. This percentage translates to one or two confirmed cases each school year.
Although many men and women infected with gonorrhea notice no symptoms at all, the infection can cause lasting damage to the reproductive tract and is the leading cause of Pelvic Inflammatory Disease in women.
“The infection can simmer along undetected and cause scarring that leaves women infertile,” said Hall.
When they do appear, symptoms of gonorrhea include a burning sensation when urinating and off-colored discharge, along with a severe fever. The infection can grow in the cervix, uterus or fallopian tubes in women, and in the urine tract, mouth, eyes and ears for either men or women.
Following a movement in the mid-1970’s to reduce the rate of gonorrhea in the U.S., infection rates dropped. The new drug-resistant strain, however, has renewed concerns about the STD.
“Gonorrhea has now joined the list of other super-bugs for which treatment options have become dangerously few. To make a bad problem even worse, we’re also seeing a decline in the development of new antibiotics to treat these infections,” stated Henry Masur, M.D., president of the Infectious Diseases Society of America, in a press release on April 12.
Recently, like many bacteria, gonorrhea has become a “super-bug” due to over-medication and exposure to antibiotics like Cipro, a form of the fluoroquinolone drug.
“When bacteria replicate and multiply, the DNA splits into two, a process that inevitably results in mutations. Sometimes these mutations can be helpful and offer a survival benefit for the bacteria — there was a benefit for gonorrhea to become resistant to the Cipro antibiotic,” Hall said.
Gonorrhea is the second most common sexually transmitted disease in the U.S., according to the Infectious Diseases Society of America. The IDSA warned against increased risk of contracting HIV for people with gonorrhea. Due to a strong tax on the immune system as it fights the gonorrheal infection, the body is more susceptible to other STDs. Not only is it easier to contract HIV if you have gonorrhea, it is also easier for an HIV-infected person with gonorrhea to infect their partner with HIV.
Using condoms effectively prevents the spread of gonorrhea. Gannett offers testing upon request, but does not recommend routine screening as it does for other, more contagious STDs.