- The Washington Times - Tuesday, August 7, 2012

For decades, gonorrhea patients could expect to quickly dispatch the long-dreaded sexually transmitted disease with a time-tested round of antibiotics.

But the ever-mutating gonorrhea bacterium is becoming resistant to the dwindling number of medicines used to fight it, and public health authorities are raising alarms about the emergence of an untreatable “superbug” that will reverse decades of progress in lowering infection and transmission rates around the globe.

On Thursday, officials with the Centers for Disease Control and Prevention (CDC) are scheduled to release new treatment guidelines to slow the growth of antibiotic-resistant gonorrhea in the United States.

These guidelines are coming none too soon, said William Smith, executive director of the National Coalition of STD (Sexually Transmitted Disease) Directors.

“It is pretty clear that we have already seen significant resistance to the existing [gonorrhea] treatments, and internationally, we have seen complete treatment failures,” he said. “So right now is the time to be just ahead of this, and to try and figure out how we can control it a bit longer with the existing resources that we’ve got.”

“Complete treatment failure,” Mr. Smith said, means just what it sounds like — “that you have a chronic, active, ulcerative, infectious disease.”

Adaptable scourge

Gonorrhea, which has been known since biblical days, was a global scourge until the 1940s, when sulfa drugs were developed to vanquish it.

But the bacterium, Neisseria gonorrhoeae, proved to be a master of mutation. Over time, it learned how to survive against entire classes of antibiotics, including penicillins, tetracyclines and fluoroquinolnes.

Now only two drugs — ceftriaxone or cefixime — are recommended to treat gonorrhea. Both usually are fortified with another antibiotic.

In recent years, however, cases of complete treatment failure have been reported in Europe, Asia and Canada.

In July 2011, researchers said a gonorrhea strain, named H041, was identified in the throat of a Japanese sex worker.

The H041 strain was dubbed a “superbug” because it was resistant to all known antibiotics. When researchers cultivated it with other gonorrhea strains, it produced even more resistant strains of the sexually transmitted infection.

Antibiotic-resistant gonorrhea is “a major global threat,” Dr. Edward W. Hook III told a CDC webinar in May.

If this gets out of control, it “could take us back more than 60 years, to a time when treatments for gonorrhea were not reliably effective and when there were no alternative therapies,” said Dr. Hook, a professor of medicine and epidemiology at the University of Alabama and director of the STD Control Program for the Jefferson County Department of Health.

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