Federal researchers say a cluster of gonorrhea cases in Hawaii are the first in the nation to show resistance to the strongest antibiotics available to combat the sexually transmitted disease.
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USA health officials have identified a cluster of gonorrhea infections that show sharply increased resistance to the last effective treatment available for the country’s second most commonly reported infectious disease.
“Our last line of defense against gonorrhea is weakening”, Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention said in a statement.
Though no failures of the current treatment regimen have been confirmed in the United States, the CDC has been closely monitoring antibiotic resistance. At the same conference, researchers from Louisiana State University reported on an experimental oral antibiotic now being tested that could offer a new option for treating gonorrhea. Norway’s prime minister spoke about how her country has been vaccinating every single “baby salmon, just like small kids”, and as a result, has cut antibiotic use in one of its principal foods and exports to virtually zero.
In a related development, the CDC today also noted promising early clinical findings for a candidate antibiotic meant to treat gonorrhea. It is a single-dose oral therapy, and could be used as an alternative to ceftriaxone injection.
Not only do the seven cases in Hawaii represent azithromycin-resistant strains, the resistance is dramatically higher than levels typically scene in America, the CDC said, citing research from the Hawaii State Department of Health. In addition, isolates from five of the patients showed decreased susceptibility to ceftriaxone. All patients were treated successfully, but the level of resistance was disturbing.
In an Entasis press release, President and CEO Manos Perros, PhD, said, “ETX0914 is a novel oral antibiotic created to be highly active against both the drug-sensitive and drug-resistant bacteria which cause gonorrhea”.
“We’ve been one of the first states to see declining effectiveness of each drug over the years”, he said. But this is the first time a cluster of such cases has been seen in the US. That has made the state monitor resistance patterns closely so they were able to catch this cluster of cases early. “But the future risk of gonorrhea becoming resistant to both of the recommended therapy medications in the United States is troubling”. Researchers announced their findings on the same day the United Nations launched an global plan for fighting drug-resistant superbugs, calling them a “fundamental threat” to humanity.
And since infections in other members of the cluster would remain susceptible to ceftriaxone, they might not have been picked up, either by culture testing or treatment failure, Katz noted.
If this combination of drugs fail, there is no other treatment option now available. Left untreated, the infection can cause serious health problems including long-term abdominal pain and pelvic inflammatory disease, which could lead to ectopic pregnancy and infertility.
The CDC said data presented by the LSU researchers on ETX0914, developed by Entasis Therapeutics, indicated the experimental antibiotic is generally safe and effective. One antibiotic showed promise in a recent clinical trial testing for safety in humans. An experimental drug from the Louisiana State University Health Sciences Center works differently from other medicines and is expected to be more efficient.
The experimental drug works differently from any now marketed antibiotic.
All 47 patients receiving 3 grams and 48 of 49 receiving 2 grams of ETX0914 were cured. About 12 percent of patients reported mostly mild side effects that included gastrointestinal problems.
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“In Hawaii, the system worked”, said Dr. Mermin. New in 2016, CDC used additional resources targeted for addressing antibiotic resistance to bolster existing state and local STD programs; to introduce new laboratory tools and services; and build rapid response capacity for outbreak response.
