World Health Organization (WHO) announced a bacteria that cause gonorrhoea, which is a common sexually-transmitted infection, is much harder, and sometimes impossible, to treat. Dr Teodora Wi, Medical Officer, Human Reproduction, at WHO said that these bacteria are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.
WHO reports widespread resistance to older and cheaper antibiotics. Some countries – particularly high-income ones, where surveillance is best – are finding cases of the infection that are untreatable by all known antibiotics.
"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," adds Dr Wi.
Each year, an estimated 78 million people are infected with gonorrhoea*. Gonorrhoea can infect the genitals, rectum, and throat. Complications of gonorrhoea disproportionally affect women, including pelvic inflammatory disease, ectopic pregnancy and infertility, as well as an increased risk of HIV.
Decreasing condom use, increased urbanization and travel, poor infection detection rates, and inadequate or failed treatment all contribute to this increase.
Currently, in most countries, extended-spectrum cephalosporins (ESCs) are the only single antibiotic that remain effective for treating gonorrhoea. WHO issued updated global treatment recommendations in 2016 advising doctors to give 2 antibiotics: ceftriaxone and azithromycin.
Gonorrhoea can be prevented through safer sexual behaviour, in particular consistent and correct condom use. Information, education, and communication can promote and enable safer sex practices, improve people’s ability to recognize the symptoms of gonorrhoea and other sexually transmitted infections, and increase the likelihood they will seek care.
The bacteria can infect the cervix (entrance to the womb), the urethra (tube through which urine passes out of the body), the rectum, and less commonly the throat or eyes.
The infection can also be passed from a pregnant woman to her baby. If you're pregnant and may have gonorrhoea, it's important to get tested and treated before your baby is born. Without treatment, gonorrhoea can cause permanent blindness in a newborn baby.
Today, lack of public awareness, lack of training of health workers, and stigma around sexually transmitted infections remain barriers to greater and more effective use of these interventions.
Gonorrhoea isn't spread by kissing, hugging, sharing baths or towels, swimming pools, toilet seats, or sharing cups, plates and cutlery, because the bacteria can't survive outside the human body for long.
There are no affordable, rapid, point-of-care diagnostic tests for gonorrhoea. Many people who are infected with gonorrhoea do not have any symptoms, so they go undiagnosed and untreated. On the other hand, however, when patients do have symptoms, such as discharge from the urethra or the vagina, doctors often assume it is gonorrhoea and prescribe antibiotics – even though people may be suffering from another kind of infection. The overall inappropriate use of antibiotics increases the development of antibiotic resistance in gonorrhoea as well as other bacterial diseases.
According to NHS UK, typical symptoms of gonorrhoea include a thick green or yellow discharge from the vagina or penis, pain when urinating and (in women) bleeding between periods. However, around 1 in 10 infected men and almost half of infected women don't experience any symptoms.
“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.”