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WHO: Gonorrhoea becoming incurable and harder to treat globally

Reshmin Kaur Cheema, 13 Jul 2017
The World Health Organisation (WHO) said in a statement recently that gonorrhoea is becoming difficult to treat. In some cases, the sexually transmitted infection is impossible to treat with the usual antibiotics.

Teodora Wi, a human reproduction specialist at the WHO stated in a press release, “The bacteria that cause gonorrhoea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.”

According to the WHO, three superbugs have been identified in Japan, France and Spain. “These are cases that can infect others. It can be transmitted. And these cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” said Wi.

Some countries reporting gonorrhoea cases “untreatable by all known antibiotics”

Annually, 78 million people worldwide are infected with gonorrhoea, said the WHO. The Centres for Disease Control and Prevention (CDC) estimates 820,000 new gonorrhoea infections cases are diagnosed in the United States every year.

Speaking at the news release, WHO said data pooled from 77 countries collected by WHO proves the widespread resistance to older, cheaper antibiotics. Gonorrhoea has even become “untreatable by all known antibiotics” in some countries, they added.

In fact, gonorrhoea was listed among 11 different bacteria that experts believe pose the greatest threats to human health. This is due to the dire need of novel antibiotics for its treatment.

There's an urgent need for drugs and tests to prevent, diagnose and treat gonorrhoea, said Marc Sprenger, WHO's director of antimicrobial resistance. He elaborated that the community not only needs new antibiotics, but also a long-term vaccine to prevent the infection and accurate tests to predict the efficacy of an antibiotic for a specific infection.

Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership said, “It's important to understand that ever since antibiotics appeared on the scene, Neisseria gonorrhoea has been fairly quick in developing resistance to all the classes of antibiotics that have been thrown at it.”

“To address the pressing need for new treatments for gonorrhoea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline,” he added.

“In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use.”

Improper antibiotic use, foregoing condoms and poor detection contribute to resistance

The WHO reported that between 2009 and 2014, there was a widespread resistance to certain antibiotics used to treat gonorrhoea such as ciprofloxacin, azithromycin and even extended-spectrum cephalosporins (ESCs).

Last year, WHO advised clinicians to treat the infection with a two-drug combination – ceftriaxone and azithromycin. This came after over 50 countries declared that, in certain cases, ESCs were not effective anymore.

WHO said that creating new antibiotics is “not very attractive for commercial pharmaceutical companies”. They acknowledged that the improper use of antibiotics such as patients not completing their course is contributing to the antibiotic resistance in gonorrhoea and other bacterial infections. Other reasons driving the increase in infection rates and resistance are such as decreasing condom use, increased urbanisation, poor infection detection and global travel.

Managing the infection has been made difficult by a lack of public awareness, lack of health professionals training and a stigma surrounding sexually transmitted infections, added the WHO.

As cases are seen to be rising in high-income countries, Wi reasons that the situation is unquestionably worse in low-income countries that report higher infection rates. “We need to be more vigilant,” she expressed. MIMS

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