Strains of STD ‘su­per­bug’ spread­ing

An­tibi­otics could soon be of no use for treat­ment of gon­or­rhoea, ex­perts say

The Star Early Edition - - NEWS - REUTERS

AT LEAST three peo­ple world­wide are in­fected with to­tally un­treat­able “su­per­bug” strains of gon­or­rhoea which they are likely to be spread­ing to oth­ers through sex, the World Health Or­gan­i­sa­tion (WHO) says.

Giv­ing de­tails of stud­ies show­ing a “very se­ri­ous sit­u­a­tion” with re­gard to highly drug-re­sis­tant forms of the sex­u­ally-trans­mit­ted dis­ease (STD), WHO ex­perts said it was “only a mat­ter of time” be­fore last-re­sort gon­or­rhoea an­tibi­otics would be of no use.

“Gon­or­rhoea is a very smart bug,” said Teodora Wi, a hu­man re­pro­duc­tion spe­cial­ist at the Geneva-based UN health agency.

“Ev­ery time you in­tro­duce a new type of an­tibi­otic to treat it, this bug de­vel­ops re­sis­tance to it.”

The WHO es­ti­mates that 78 mil­lion peo­ple a year get gon­or­rhoea, an STD that can in­fect the gen­i­tals, rec­tum and throat.

The in­fec­tion, which in many cases has no symp­toms on its own, can lead to pelvic in­flam­ma­tory dis­ease, ec­topic preg­nancy and in­fer­til­ity, as well as in­creas­ing the risk of get­ting HIV.

Wi, who gave de­tails in a brief­ing of two stud­ies on gon­or­rhoea pub­lished in the jour­nal PLOS Medicine, said one had doc­u­mented three spe­cific cases – one each in Ja­pan, France and Spain – of pa­tients with strains of gon­or­rhoea against which no known an­tibi­otic is ef­fec­tive.

“These are cases that can in­fect oth­ers. It can be trans­mit­ted,” she said.

“These cases may just be the tip of the ice­berg, since sys­tems to di­ag­nose and re­port un­treat­able in­fec­tions are lack­ing in low­er­in­come coun­tries where gon­or­rhoea is ac­tu­ally more com­mon.”

The WHO’s pro­gramme for mon­i­tor­ing trends in dru­gre­sis­tant gon­or­rhoea found in a study that from 2009 to 2014 there was wide­spread re­sis­tance to the first-line medicine ciprofloxacin, in­creas­ing re­sis­tance to an­other an­tibi­otic drugs called azithromycin, and the emer­gence of re­sis­tance to last-re­sort treat­ments known as ex­tended-spec­trum cephalosporins (ESCs).

In most coun­tries, it said, ESCs were now the only sin­gle an­tibi­otics that re­mained ef­fec­tive for treat­ing gon­or­rhoea.

Yet re­sis­tance to them has al­ready been re­ported in 50 coun­tries.

Man­ica Balasegaram, di­rec­tor of the Global An­tibi­otic Re­search and De­vel­op­ment Part­ner­ship, said the sit­u­a­tion was “grim” and there was a “press­ing need” for new medicines.

The pipe­line, how­ever, was very thin, with only three po­ten­tial new gon­or­rhoea drugs in de­vel­op­ment and no guar­an­tee any would prove ef­fec­tive in fi­nal-stage tri­als, he said.

“We ur­gently need to seize the op­por­tu­ni­ties we have with ex­ist­ing drugs and can­di­dates in the pipe­line,” Balasegaram said.

“Any new treat­ment de­vel­oped should be ac­ces­si­ble to ev­ery­one who needs it, while en­sur­ing it is used ap­pro­pri­ately, so that drug re­sis­tance is slowed as much as pos­si­ble.”

SMART BUG: Ev­ery time a new type of an­tibi­otic is in­tro­duced to treat gon­or­rhoea the bug de­vel­ops re­sis­tance to it, the WHO says.

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