Drug-resistant gonorrhea detected in Massachusetts

  • Two patients in Massachusetts were exposed to a new multidrug-resistant strain of gonorrhea.
  • The patients recovered, but the bacteria was resistant to several antibiotics.
  • Gonorrhea is the second most common STI in the US — and it’s on the rise.

Health officials have been on high alert since a new strain of gonorrhea was discovered this week in Massachusetts that is showing signs of resistance or reduced sensitivity to all the drugs recommended for treatment.

Two apparently unrelated cases of gonorrhea were either resistant to treatment, or more difficult than usual to treat, with five classes of antibiotics, according to a press release from the state health department.

While both cases were eventually cured with ceftriaxone — the antibiotic currently recommended to treat gonorrhea — the bacteria wasn’t as susceptible to the medication as it usually was, according to a warning the Massachusetts Department of Public Health sent to clinicians. In other words, it turned into a fight.

This is the first time a strain of gonorrhea in the U.S. has shown resistance or a reduced response to not just one, but seven different drugs across five classes of antibiotics, the doctor’s alert said. Two other drugs in the same class as ceftriaxone also showed reduced efficacy in lab tests, along with four unrelated antibiotics.

Gonorrhea is on the rise in the US

While several options used to be available to treat gonorrhea, the supply of drugs that can successfully stop the infection is dwindling just as the number of infections in the US is increasing. The number of new cases of gonorrhea increased 10% by the end of 2020 compared to the previous year, according to the CDC. Overall, gonorrhea cases have increased by 131% since 2009, becoming the second most common sexually transmitted infection in the US.

The disease often has no symptoms, but if there are symptoms, it may include a burning sensation when urinating; unusual discharge from the penis or vagina; and bleeding between periods, according to the CDC. These symptoms may also indicate another STI, such as chlamydia.

Gonorrhea has already developed resistance to some antibiotics

In the 1990s, there were a few different antibiotics prescribed to treat gonorrhea. Infected patients had a choice of ceftriaxone or cefixime – both cephalosporins – or ciprofloxacin, which is from a different class of medication.

However, strains of gonorrhea resistant to ciprofloxacin soon appeared to be circulating in Hawaii and on the West Coast, according to the CDC. The agency stopped recommending the drug as a gonorrhea treatment in 2007.

Now public health officials fear that our best existing treatment for gonorrhea could suffer the same fate.

“The discovery of this form of gonorrhea is a serious public health problem that DPH, the CDC and other health departments have been vigilant about,” Margret Cooke, chief of the Massachusetts Department of Public Health, said in a statement Thursday.

Genetic sequencing revealed that the strain had a marker for reduced sensitivity to ceftriaxone, but it’s not yet clear how far the strain has spread. According to the alert sent to clinicians in Massachusetts, eight cases of the same sequence type were identified in the UK between December 2021 and June 2022, with some cases also seen in Asia.

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