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sex, STDs

Multidrug resistant gonorrhea isolated in Japan: I have a bad feeling about this…

CDC/James Volk

Researchers in Japan are reporting a strain of gonorrhea that is resistant to the last standing class of antibiotics effective against this bacteria. While this report, all over the web today, will probably fade from news obscurity, we shouldn’t let it. This is big news people, and hear me now when I say it’s only a matter of time before this strain makes it way to the United States.

Gonorrhea is a highly effective freedom fighter, having developed resistance to every other single antibiotic therapy. In fact, as soon as we find a new drug class to treat gonorrhea, it seems within 10 years that good old gram-negative diplococci has developed a highly effective defense mechanism. It is the cockroach of STDs.

Let’s look at the history of antibiotics and gonorrhea:

Initially we used sulfa drugs. Now resistant.

Then penicillin. Now resistant.

Then tetracyclines. Now resistant.

Then 3rd generation cephalosporins. Standard of care in United States.

Then fluoroquinolones. Now resistant.

Then Azithromycin. Resistant strains have been reported in Hawaii and also in San Diego. Contact tracing tells us that some of these cases of Azithromycin resistance were acquired in the US, not imported from elsewhere and then diagnosed here. So resistance not widespread, but it’s there and will be widespread rapidly.

So we will still have those cephalopsorins, right? Well, that’s what that is exactly what this new strain is resistant to. The last known weapon has fallen. If what has happened to other classes of antibiotics holds true for cephalosporins, it will take about 10-20 years for this multi-drug resistant strain to become widespread. Or perhaps less time.

And then what happens? Untreated gonorrhea in women can cause severe pelvic infections and infertility.

While researchers scramble to develop more antibiotics, what we can do now is talk about this. A lot. Tell everyone, WEAR CONDOMS and insist your partners get tested for gonorrhea. Ask to see the pdf with the negative test. Doesn’t sound romantic, you say? Well, it sounds a lot better than multi-drug resistant gonorrhea.


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