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07-06-2012 | Article

Rate of drug-resistant gonorrheal infections climbs

Abstract

WHO - Global action plan

MedWire News: An old scourge of mankind is making an unwelcome comeback, according to a report from the World Health Organization showing drug-resistant gonorrheal infections are on the rise worldwide.

Gonorrhea resistant to cephalosporins - the antibiotics of last resort against the sexually transmitted infection - have been reported in Australia, France, Japan, Norway, Sweden, the UK, and other countries, the WHO notes.

"Gonorrhoea is becoming a major public health challenge, due to the high incidence of infections accompanied by dwindling treatment options," said Manjula Lusti-Narasimhan (WHO Department of Reproductive Health and Research, Geneva, Switzerland) in a statement.

"The available data only shows the tip of the iceberg. Without adequate surveillance we won't know the extent of resistance to gonorrhea and without research into new antimicrobial agents, there could soon be no effective treatment for patients," she added.

The infectious organism, Neisseria gonorrhoeae, can acquire antimicrobial resistance across antibiotic classes, allowing it to gain both genetic and phenotypic resistance to several different anti-infective drug classes simultaneously, according to the WHO "Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae."

The plan calls for campaigns to increase the awareness of the correct use of antibiotics by both patients and healthcare providers, with particular targeting of messages to at-risk populations, including men who have sex with men, and sex-trade workers.

It also calls for systematic surveillance and verification of treatment failures, with particular emphasis on countries with high rates of gonococcal and HIV infections and other STIs; prevention, diagnosis, and adequate treatment; improved regional laboratory networks for culturing gonoccoci; research into molecular methods for detecting antimicrobial resistance; and research into developing effective alternative treatment regimens for gonoccocal infections.

"We are very concerned about recent reports of treatment failure from the last effective treatment option - the class of cephalosporin antibiotics - as there are no new therapeutic drugs in development," Lusti-Narasimhan said. "If gonococcal infections become untreatable, the health implications are significant."

By Neil Osterweil