New Multi-Drug Resistant Gonorrhea Detected In U.S., 2 Cases In Massachusetts

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This version of Neisseria Gonorrhoeae had reduced susceptibility to ceftriaxone, cefixime and azithromycin and full resistance to ciprofloxacin, tetracycline, and penicillin.

What’s worse than being told that you have gonorrhea? How about being told that you are the first case in the U.S. of gonorrhea that has either no response or reduced response to five different classes of antibiotics? Yep, that’s what recently happened to not one but two people in Massachusetts, according to a January 19 announcement from the Massachusetts Department of Public Health (DPH). They were infected with a strain of Neisseria gonorrhoeae bacteria that’s even harder to treat, which is kind of like getting kicked in the groin and then falling forwards groin-first on to a bowling ball. Think about the burning sensation that drug-resistant gonorrhea may give you the next time you are on a Tinder date and forego using condoms because “it feels better without a condom.”

An alert letter from the Centers for Disease Control and Prevention (CDC) to health professionals described how these cases were found. The first case went to a primary care clinic after experiencing urethritis symptoms. Urethritis, which is pronounced “your a thritis” as opposed to “we all are thritis,” is inflammation of your urethra. Your urethra is that tube that runs from your bladder to where pee comes out of your body. When you have such inflammation, you may feel the urge to urinate even when you don’t need to urinate. That’s called urinary urgency, which is a little different from the urgency you get when you are trying to sell your bitcoin before its price drops any further. Other possible signs of urethritis include difficulty starting urination, feeling itching, pain, or discomfort down there, or a discharge or blood coming out of your urethral opening.

The health professionals at the clinic took specimens from the patient’s urethra and then found N. gonorrhoeae in those specimens. The Massachusetts State Laboratory conducted further testing, which revealed that this bacteria was unusually resistant to different antibiotics, and then subsequently sent the samples to the CDC for even more testing. It turned that this N. gonorrhoeae had reduced susceptibility to ceftriaxone, cefixime and azithromycin and full resistance to ciprofloxacin, tetracycline, and penicillin. It was the first documented case in the U.S. of N. gonorrhoeae being at least partially resistant to six of the seven antibiotics typically tested as part of the standard GISP (Gonococcal Isolate Surveillance Project) panel. The reduced susceptibility to ceftriaxone seemed to be the result of a penA60 allele mutation.

Searching available samples from other patients in Massachusetts found this mutation to be present in N. gonorrhoeae from another patient, thus identifying the second case in the state. Fortunately, both cases of gonorrhea were only partially resistant to ceftriaxone, an antibiotic recommended by the CDC to treat gonorrhea. Therefore, doctors could successfully use ceftriaxone, specifically a single injection of ceftriaxone 500 mg intramuscularly, to get rid of the infections in both cases. Nevertheless, finding this new drug-resistant version of N. gonorrhoeae ain’t good news. The concern is that eventually this version of the bacteria may some day mutate to the point that none of the available antibiotics work.

Of note, these two cases didn’t seem to be related in any way, unless the two were playing the “Never saw that person in my life” game. Therefore, there could be other people quietly carrying this new multiple drug-resistant version of N. gonorrhoeae. Let’s hope that not too many people who indicate that they have a “growth mindset” on their dating profiles aren’t referring to the growth of N. gonorrhoeae.




New Multi-Drug Resistant Gonorrhea Detected In U.S., 2 Cases In Massachusetts (forbes.com)
 
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