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A CDC report released last week warned that cephalosporin-resistant gonorrhea is now emerging in the United States.  It’s not the first strain of gonorrhea to develop resistance to antibiotics, but it’s one of the more troubling.

Penicillin-resistant gonorrhea strains first emerged in the 1970s, followed by fluoroquinolone-resistant strains in the mid-2000s.  Now, four years after the CDC discontinued its recommendation of treating gonorrhea with fluoroquinolone antibiotics, cephalosporin resistance is on the rise.   The resulting recommendation from CDC is to treat gonorrhea with a dual antibiotic therapy of ceftriaxone (a cephalosporin) and either azithromycin or doxycycline.  An editorial note attached to the CDC report explains why cephalosporin-resistance is worrying:

The potential emergence of gonococcal cephalosporin resistance is of particular concern because the U.S. gonorrhea control strategy relies upon effective antibiotic therapy. Previously, the emergence and spread of gonococcal antibiotic resistance in the United States was addressed by changing the recommended antibiotics for treatment. No other well-studied and effective antibiotic treatment options or combinations currently are available. The emergence of gonococcal cephalosporin resistance would substantially limit available treatment options.

The CDC report came just three days before scientists at the International Society for STD Research conference in Quebec reported the discovery of a new, extensively resistant strain of gonorrhea in Japan.  The research team led by Dr Magnus Unemo at the Swedish Reference Laboratory for Pathogenic Neisseria found that the strain, H041, is resistant to all known antibiotics – a result that Unemo told Time was both “alarming and predictable.” The quote aptly describes the broader march towards drug resistance – predictable because we know that the emergence of resistance is a naturally occurring evolutionary consequence of using antibiotics, but alarming nonetheless when faced with the reality of dwindling treatment options.

Perhaps it’s time for new round of PSAs about STDs…

Read the CDC report, Cephalosporin Susceptibility Among Neisseria gonorrhoeae Isolates --- United States, 2000—2010


Image credit: U.S. Public Health Service (1940s), via Flickr: centralasian