Posts Tagged ‘Antibiotic resistant gonorrhea’

Guess that it was bound to happen.
Was just a matter of time.
But now I’ve come to my decision,
And it’s one of the painful kind.
‘Cause now it seems that you wanted a martyr.
Just a regular guy wouldn’t do.
But baby I can’t hang upon no lover’s cross for you.
~ Jim Croce

This sweet, sad lyric by Jim Croce may well be the new anthem in the sexual revolution, as word comes recently from the Centers for Disease Control and Prevention that strains of Gonorhhea that are resistant to all antibiotics have now emerged. Get all of the details in the link. From the report:

In the July 8, 2011 issue of CDC’s Morbidity and Mortality Weekly Report, researchers analyzed gonorrhea surveillance data and concluded that, although there have been no documented treatment failures yet, untreatable gonorrhea may become a reality in the U.S.

Gonorrhea, one of the most common sexually transmitted diseases (STDs), can have serious health consequences, including infertility in women, and can increase a person’s risk for acquiring HIV. Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. While antibiotics can successfully treat gonorrhea, over time thebacteria has developed resistance to several of these drugs, including sulfonamides,penicillin, tetracycline, and most recently, in 2007, fluoroquinolones. CDC now recommends only one class of antibiotics, called cephalosporins — consisting of the drugs cefixime (administered orally) or ceftriaxone (administered via injection) — together with another antibiotic, either azithromycin or doxycycline. However, findings from the recent analysis signal the potential for resistance to cephalosporins, the last line of defense for treating gonorrhea.

Now, in plain English, here’s what’s going on. CDC has a surveillance project where they collect gonorrhea samples at 30 clinics throughout the U.S. and send the bacteria to the lab for analysis. They look for the smallest dose of antibiotic needed to inhibit the growth of the bacteria. This is called the Minimum Inhibitory Concentration (MIC), as it is the minimum concentration needed to inhibit growth.

Now, as bacteria develop resistance over time from intermediate to severe resistance, the amount of drug needed to inhibit their growth rises. So larger doses of drug are needed. We call this decreased susceptibility So, as susceptibility decreases, MIC of the drug increases.

What has been discovered is that there are now strains of gonorrhea on the West Coast of the U.S. that are increasingly resistant to the last line of defense antibiotics:

And while the numbers were small, researchers observed an increase in the percentage of cases that crossed this threshold in recent years — from 0.02 percent for 2000–2006
to 0.11 percent for 2009–2010. Of note, all of the isolates with decreased susceptibility to cefixime were collected from gay or bisexual men.

Patterns of elevated MICs were most prominent in samples collected in the western United States, and among gay and bisexual men:

Western regions: For cefixime, the proportion of samples from the West with elevated MICs rose from zero percent in 2000 to 3.3 percent in 2010. Significant increases in the proportion of isolates with elevated MICs were noted in Hawaii (from 0 to 7.7 percent) and California (from 0 to 4.5 percent) between 2000 and 2010. Smaller, but still significant, increases were seen for ceftriaxone in the same time period in
the west: the percentage of isolates with elevated MICs rose from zero to 0.5 percent.

Men who have sex with men (MSM): For cefixime, the proportion of isolates with elevated MICs rose from zero to 4 percent between 2000 and 2010; for ceftriaxone, the proportion of isolates with elevated MICs rose from zero to 0.9 percent.

These numbers may seem rather small, but already in other parts of the world, we now have gonorrhea that is entirely antibiotic resistant. HIV gained a foothold in the gay community by stealth, and the same is true with gonorrhea, as less than half of all cases are believed to be reported in the US, annually.

To make matters worse, gonorrhea has often been regarded by folks as no big deal, as antibiotics can clear it up. However, while some may take days to weeks to manifest symptoms, many people never manifest symptoms for months. Left untreated, this disease is quite destructive, and even deadly. From CDC:

Untreated gonorrhea can cause serious and permanent health problems in both women and men.

In women, gonorrhea is a common cause of pelvic inflammatory disease (PID). About 750,000 women each year in the United States develop PID. The symptoms may be quite mild or can be very severe and can include abdominal pain and fever. PID can lead to internal abscesses (pus-filled “pockets” that are hard to cure) and long-lasting, chronic pelvic pain. PID can damage the fallopian tubes enough to cause infertility or increase the risk of ectopic pregnancy. Ectopic pregnancy is a life-threatening condition in which a fertilized egg grows outside the uterus, usually in a fallopian tube.

In men, gonorrhea can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to infertility if left untreated.

Gonorrhea can spread to the blood or joints. This condition can be life threatening. In addition, people with gonorrhea can more easily contract HIV, the virus that causes AIDS. HIV-infected people with gonorrhea can transmit HIV more easily to someone else than if they did not have gonorrhea.

This is a public health disaster in the making. We can’t just come up with new antibiotics, as the economic pressures are against antibiotic development. It costs over $800 Million to discover, purify, lab test, animal test, and go through FDA Phase I, II, III human trials, mass produce and market an antibiotic. The process takes about ten years, on average, using 10 of the 18 years on the drug’s patent. That only leaves about 8-9 years for the company to recoup their costs and turn a profit before the patent expires. Unlike most other medications which people take daily for life, antibiotics are only taken for 7-10 days. The profit incentive is just not there.

Worse still for gays is the coupling of increased resistance to antibiotics with the steady rise of gonorrhea in the community of men having sex with men, as the following CDC slide indicates:

Figure Y. Gonococcal Isolate Surveillance Project (GISP)—Percentage of Urethral Neisseria gonorrhoeae Isolates Obtained From MSM* Attending STD* Clinics, 1990–2009

Cardinal O’Connor was fond of saying that good morality is good medicine. He was crucified for it in the media. Gays, Bisexuals, and then promiscuous heterosexuals are about to hang upon their own lover’s crosses unless they wake up and realize that condoms just don’t work.


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