Gonorrhea is a communicable disease caused by bacteria that can be transmitted through copulation. The disease is one of many sexually transmitted infections that affect more than one million people worldwide. And one them in the United Kingdom caught a superbug strain of gonorrhea.

Superbug Gonorrhea Resists First-Line Antibiotics

A man living in the United Kingdom whose identity was not revealed contracted a rare strain of gonorrhea in South East Asia. The rare strain is resistant to the first-line of antibiotics – azithromycin and ceftriaxone - which are recommended to treat the disease.

"This is the first time a case has displayed such high-level resistance to both of these drugs and to most other commonly used antibiotics," said Dr. Gwenda Hughes, head of the sexually transmitted infection division at the Public Health England.

According to the Centers for Disease Control and Prevention, the current standard treatment for gonorrhea is dual therapy. In dual therapy, the patient must be administered with a single dose of 250mg intramuscular injection of ceftriaxone and one gram of oral azithromycin. If ceftriaxone is not available, cefixime 400 mg oral administration combined with one gram of oral azithromycin may be used.

In case the patient has an allergy to azithromycin, a 100 mg doxycycline administered orally for two times a day within a week may be used. However, some oral cephalosporins are not recommended, such as cefuroxime and cefpodoxime, because of their lower efficacy to kill the bacteria. The use of dual therapy has been the standard because of the resistance to tetracycline antibiotics, such as doxycycline, minocycline, and tetracycline.

"The thing that's been going on is, over the years we've been seeing gonorrhea's increasing resistance to drugs. This isn't surprising to anyone in the STD field. And it's not going to get better," stated Dr. Lee Wetzler, an infectious disease specialist at Boston Medical Center.

The unnamed man is still being treated but with a different antibiotic called ertapenem. Doctors would know if the antibiotic is working in at least a month. His relationship partner in the UK has been confirmed free of the STI, while the authorities are still looking for the female partner who might be the carrier of the superbug.

Researchers are developing new options to treat gonorrhea and a vaccine that can protect people from it. According to Teodora Wi, a medical officer at the Department of Reproductive Health and Research at the World Health Organization, the gonorrhea bacteria has been difficult to eradicate because of its ability to resist newer classes of antibiotics. The unnatural ability of the bacteria to evolve and develop resistance made it nearly impossible to treat.

How Bad Gonorrhea Can Be

The Neisseria gonorrhoeae bacterium is responsible for causing gonorrhea in humans, but it does not cause symptoms in about 1 of every 10 cases or 90 percent of all cases, which makes it easy to contract and transmit. If the carrier is symptomatic, certain clinical signs would be noticeable:

- In men, the infection can cause a colored white, green or yellow discharge from the penis. Men who are infected may also experience painful, swollen testicles.

- In women, the infection can cause vaginal bleeding in between periods and vaginal discharge.

- Both genders can experience a burning or painful sensation when urinating.

According to the CDC, most women do not present any symptoms at all, while some men do present noticeable signs of the disease. Gonorrhea can also cause anorectal infection characterized by discharge, itching, bleeding, and a painful sensation.

Untreated gonorrhea is rarely lethal on its own, rather, the infection slowly deteriorates the health of the person. Several health complications of untreated gonorrhea include:

- Inflammation of the reproductive system, including the prostate gland and urethra, among men.

- Pelvic inflammatory disease that can bring chronic abdominal or pelvic pain, among women.

- Increased risk of developing prostate cancer.

- Infertility and pregnancy-related complications.

- Neonatal blindness due to conjunctivitis.

- Increased risk of contracting HIV.

Those who have been treated for gonorrhea do not develop immunity, which means they can still contract the disease. While those who are asymptomatic can repeatedly infect other people for several years.

Ertapenem: Last Line of Defense against Gonorrhea

Ertapenem has been used to treat super gonorrhea in an infected man. Ertapenem is an antibiotic from the carbapenem class, a class of antibiotics used to treat multidrug-resistant bacterial infections. But unlike other carbapenems, ertapenem has a less broad-spectrum activity and only affects certain bacteria.

The antibiotic is administered intravenously and works by stopping the synthesis of bacterial cell walls, leading to the death of bacteria. However, there are several side effects caused by this drug including fever, abdominal pain, low blood pressure, confusion, insomnia, and dyspnea. In rare cases, certain side effects, such as hives, breathing difficulty, swallowing problems, irregular heartbeat, and chest pain may occur.

[메디컬리포트=Ralph Chen 기자]