Gonorrhea became more drug resistant during COVID-19. A molecular biologist explains the sexually transmitted superbug

COVID-19 has rightly dominated the news about infectious diseases since 2020. However, that doesn’t mean other infectious diseases have taken a break. In fact, US rates from infection due to gonorrhea have increased during the pandemic.

Unlike COVID-19, a new virus, gonorrhea is an old disease. The first known reports of gonorrhea date from China in 2600 BC, and the disease has plagued people ever since. Gonorrhea has long been one of the most reported bacterial infections in the US. It is caused by the bacterium Neisseria gonorrhoeae, which can infect the mucous membranes of the genitals, rectum, throat and eyes.

Gonorrhea is usually transmitted through sexual contact. It is sometimes referred to as “the blow.”

Prior to the pandemic, there were about 1.6 million new gonorrhea infections every year. More than 50% of those cases involved strains of gonorrhea that had no longer respond to treatment with at least one antibiotic.

Gonorrhea infections initially in 2020 went down 30%, most likely due to pandemic lockdowns and social distancing. By the end of 2020 – the last year for which data from the Centers for Disease Control and Prevention is available –reported infections increased by 10% from 2019.

It is unclear why the number of infections has increased, even though some social distancing measures were still in place. But the CDC notes that reduced access to health care may have resulted in longer infections and more likely to spread the disease, and sexual activity may have increased when the first orders on site were withdrawn.

As a molecular biologistI have been study bacteria and working to develop new antibiotics to treat drug-resistant infections for 20 years. During that time, I have seen the problem of antibiotic resistance take on a new urgency.

Gonorrhea in particular is a major public health problem, but there are concrete steps people can take to prevent it from getting worse, and new antibiotics and vaccines could improve care in the future.

How do you recognize gonorrhea?

Around half of gonorrhea infections are asymptomatic and can only be detected through screening. Infected people without symptoms can unknowingly spread gonorrhea to others.

typically early signs of symptomatic gonorrhea include a painful or burning sensation when urinating, vaginal or penile discharge, or anal itching, bleeding, or discharge. Left untreated, can cause gonorrhea blindness and infertility. Treatment with antibiotics can cure most cases of gonorrhea, as long as the infection is prone to: at least one antibiotic.

There is currently only one recommended treatment for gonorrhea in the US – an antibiotic called ceftriaxone – because the bacteria have become resistant to other antibiotics that have been used. previously effective against. In the past, seven different families of antibiotics have been used to treat gonorrhea, but many strains are now resistant to one or more of these drugs.

Why gonorrhea is on the rise

A few factors have contributed to the rise in infections during the COVID-19 pandemic.

The CDC is monitoring the emergence and spread of drug-resistant gonorrhea strains.

Early in the pandemic, most U.S. labs capable of testing for gonorrhea switched to testing for COVID-19. These labs have suffered the same thing staff shortages and supplies that affect medical facilities across the country.

Many people have avoided clinics and hospitals during the pandemic, reducing the chances of identifying and treating gonorrhea infections before they spread. In fact, because of reduced screening in the past two and a half years, health experts don’t know exactly how much antibiotic-resistant gonorrhea has spread.

Also in the pandemic many doctors asked antibiotics prescribed to COVID-19 patients even though antibiotics don’t work on viruses like SARS-CoV-2, the virus that causes COVID-19. inappropriate use of antibiotics can contribute to greater drug resistance, so it is reasonable to suspect that this has happened in gonorrhea.

Overuse of antibiotics

Even before the pandemic, resistance to antibiotic treatment for bacterial infections was a growing problem. Antibiotic-resistant gonorrhea infections in the US increased by more than 70% from 2017-2019.

Neisseria gonorrhoeae is a specialist in picking up new genes from other pathogens and from “commensal” or helpful bacteria. These beneficial bacteria can also become antibiotic resistant, giving the gonorrhea bacteria more opportunities to acquire resistant genes.

Strains resistant to ceftriaxone have been observed in other countries, including: Japan, Thailand, Australia and the UKraising the possibility that some gonorrhea infections may soon be completely untreatable.

Steps to prevention

Currently, behavioral changes are one of the best ways to limit common gonorrhea infections, especially safer sexual behavior and condom use.

However, extra efforts are needed to delay or prevent an era of untreatable gonorrhea.

Scientists can create new antibiotics that are effective against resistant strains; however, over the past 30 years, investment in this research and development has declined delayed the release from new antibiotics down to a drop. No new drugs for the treatment of gonorrhea have been introduced since 2019, although two are in the final stages of clinical trials.

Vaccination against gonorrhea is not currently possible, but could be in the future. Vaccines that are effective against the meningitis bacteria, a close relative of gonorrhea, can also sometimes cause protection against gonorrhea. This suggests that a gonorrhea vaccine should be feasible.

The World Health Organization has launched an initiative to reduce gonorrhea by 90% worldwide by 2030. This initiative aims to promote safe sexual practices, increase access to quality health care for sexually transmitted diseases, and expand testing so asymptomatic infections can be treated before they spread. The initiative also calls for more research into vaccines and new antibiotics to treat gonorrhea.

Setbacks in fighting drug-resistant gonorrhea during the COVID-19 pandemic make these actions even more urgent.

This article was republished from The conversation under a Creative Commons license. Read the original article.