A recent report by the WHO has highlighted the danger of the rising number of antibiotic resistant and untreatable gonorrhoea cases, and it has warned that current drugs could soon become ineffective against infections. This warning is based on the results of two studies carried out by WHO researchers. It was found that, by looking at data from 77 different countries, nearly two thirds of them had found cases where first-line antibiotics were not effective.
It’s estimated that 78 million people every year are infected with gonorrhoea across the world, with the number of cases found in women being significantly higher than in men. The infection is usually treatable, however it can cause serious complications, including ectopic pregnancy, pelvic inflammatory disease, an increased risk of HIV and infertility. Experts believe that poor detection rates, inadequate treatment and decreasing condom use are all contributing factors towards the increase in cases seen in recent years.
“To control gonorrhoea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures,” said Marc Sprenger, director of antimicrobial resistance at the WHO. “Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhoea.”
Similar concerns were raised by other health professionals, like Prof Claudia Estcourt, a member of the British Association for Sexual Health and HIV who said “We are markedly concerned about the rise in antibiotic resistant gonorrhoea in the UK. In a very short space of time, we have seen changes in the bacteria at an unprecedented rate, which means that many antibiotics which used to work are no longer effective. We are running out of options.”
Since antibiotics were first introduced, the bacteria neisseria gonorrhoeae which is responsible for infections has shown an astonishing ability to become resistant to antibiotics. Now what we’re seeing is not only widespread resistance to first-line antibiotics, but also for second and third lines which is causing huge concerns among both healthcare workers and scientists. “Gonorrhoea is a very smart bug,” said Teodora Wi, a human reproduction specialist at the Geneva-based UN health agency.
“Every time you introduce a new type of antibiotic to treat it, this bug develops resistance to it.” She added that “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.”
Encouraging increased condom use, better information and education and an improvement in diagnosis and treatment are among the recommendations from the WHO for future prevention. It’s thought that the lack of awareness and inadequate training giving to health workers, along with the stigma attached from sexually transmitted infections are the main barriers to improving treatment rates and protecting the public.
“To control gonorrhoea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures,” said Dr Marc Sprenger, Director of Antimicrobial Resistance at WHO. “Specifically, we need new antibiotics, as well as rapid, accurate, point-of-care diagnostic tests – ideally, ones that can predict which antibiotics will work on that particular infection – and longer term, a vaccine to prevent gonorrhoea.”
Some experts have also noted that funding issues were fueling the global problem. Prof Claudia Estcourt commented that “We are concerned that at a time of increasing drug-resistant gonorrhoea and limited treatment options, overall funding for sexual health services [in the UK] is being reduced, and a quarter of local authorities have had to reduce spending on sexual health services.”
Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership, said the situation was “grim” and there’s a desperate need for new treatments to be developed. He said “We urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline,” he said. “Any new treatment developed should be accessible to everyone who needs it, while ensuring it is used appropriately, so that drug resistance is slowed as much as possible.”