Superbug gonorrhea spreading across Europe

Reuters – Mon, Jun 11, 2012 LONDON (Reuters) - "Superbug" strains of gonorrhea which are becoming untreatable accounted for almost one in 10 cases of the sexually transmitted disease in Europe in 2010, more than double the rate of the year before, health officials said on Monday.

The drug-resistant strains are also spreading fast across the continent, officials warned. They were found in 17 European countries in 2010, seven more than in the previous year.

Gonorrhea was the second most common sexually transmitted infection (STI) in Europe in 2010, with more than 32,000 infections, data from the Stockholm-based European Centre for Disease Prevention and Control (ECDC) showed.

Even though chlamydia was the most frequently reported STI, with more than 345,000 cases, the ECDC's director singled out gonorrhea as presenting a "critical situation".

Marc Sprenger said the increase in cases of superbug strains meant there was a risk gonorrhea may become an untreatable disease in the near future.

The proportion of gonorrhea cases with resistance to the antibiotic recommended to treat the disease, cefixime, rose from 4 percent in 2009 to 9 percent in 2010.

The ECDC report follows a warning from the World Health Organisation that virtually untreatable forms of drug-resistant gonorrhea were spreading around the world.

Gonorrhea is a bacterial infection which, if left untreated, can lead to pelvic inflammatory disease, ectopic pregnancies, stillbirths, severe eye infections in babies, and infertility in men and women.

VIGILANT

It is one of the most common sexually transmitted diseases in the world and is most prevalent in South and Southeast Asia and sub-Saharan Africa.

In the United States alone, the number of cases is estimated at about 700,000 a year, according to the Centers for Disease Control and Prevention (CDC).

The emergence of drug-resistant gonorrhea is caused by unregulated access to and overuse of antibiotics, which help fuel genetic mutations within the bacteria.

"Public health experts and clinicians need to be aware of the current critical situation and should be vigilant for treatment failures," Sprenger said in a statement.

Experts say the best way to reduce the risk of even greater resistance developing - beyond the urgent need to develop new drugs - is to rapidly and accurately diagnose the disease and then treat it with combinations of two or more types of antibiotics at the same time.

This technique is used in the treatment of some other infections like tuberculosis in an attempt to make it more difficult for the bacteria to learn how to overcome the drugs.

The ECDC's sexually transmitted infections report covered data and trends on five STIs - syphilis, congenital syphilis, gonorrhea, chlamydia and lymphogranuloma venereum (LGV) - in the EU and European Economic Area from 1990 to 2010.

It found diverging trends in sexually transmitted diseases across Europe, with a rapidly increasing trend for chlamydia and slightly decreasing trends for gonorrhea and syphilis.

Genital chlamydia infections are caused by Chlamydia trachomatis bacteria which can irreversibly damage a woman's reproductive organs.

Although the disease is easily treated with antibiotics, infections can remain undiagnosed because many patients - 70 percent of women and 50 percent of men - have no symptoms and so are unaware they are carrying and passing on the infection.

(Editing by Pravin Char)

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Drug-Resistant Gonorrhea Spreading

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Drug-Resistant Gonorrhea Spreading, Says World Health Organization

ABC News – 22 hrs ago

The World Health Organization is warning medical providers around the world about the potential spread of a drug-resistant form of gonorrhea, urging them to be vigilant in spotting the disease and taking steps to stop its spread.

The health agency plans to issue a "global action plan," hoping to raise awareness of the disease and encouraging research efforts to find a cure.

"This organism has basically been developing resistance against every medication we've thrown at it," Dr. Manjula Lusti-Narasimhan, a scientist in the WHO's department of sexually transmitted diseases told The Associated Press.

She added that in a couple of years, the bacterium will no longer respond to treatment with cephalosporin antibiotics, the drugs currently used to treat gonorrhea.

Cases of antibiotic-resistant gonorrhea have so far been identified in Japan, United Kingdom, Australia, France, Sweden and Norway, the AP reported, but it's likely that there are undetected cases in other countries.

The Centers for Disease Control and Prevention warned about the rising rate of drug-resistant gonorrhea in an editorial published in the New England Journal of Medicine back in February.  So far, there have been no reports of any cases of gonorrhea resistant to cephalosporins in the U.S., the agency says on its website, but it does have a surveillance system in place.

"There is much to do, and the threat of untreatable gonorrhea is emerging rapidly," the authors wrote.

In 2006, the prevalence of resistance to cephalosporins was about 0.1 percent, but by the middle of 2011, that number rose to 1.7 percent, the authors said.  CDC's first warnings about drug resistance came in 2010.

The most alarming part of the story, they said, is that cephalosporins are the only remaining drugs of choice that work. They have to be taken along with two other antibiotics.

"A major component of the threat is that there really is no backup plan if - most likely when - these more resistant organisms become more prevalent," Dr. Kenneth Fife, an infectious disease expert and professor of medicine at Indiana University Medical School, told ABC News in response to the CDC's commentary. "There are very few new drugs that have activity against the gonococcus, no clinical trials to establish the efficacy of the few drugs that might have promise."

In many cases, there are no symptoms of gonorrhea, so an infected person can spread the disease without even knowing he or she has it.

Fife added that it's unlikely that experts will be able to prevent an outbreak from happening, so it's urgent to research and develop new treatments.

If the situation progresses to the point where we are in a "post-antibiotic era," Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center, said experts will be "hard-pressed to provide quick and effective therapy to patients."

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