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Mind the clap


Staff member
Gonorrhea superbug resistant to cefixime, other antibiotics

Diana Zlomislic
Staff Reporter

A team of Toronto doctors has identified the first cases of drug-resistant gonorrhea in North America, a startling discovery that is pushing health care officials across the continent into action.

“It’s taking a lot more drug to kill the bug,” said Dr. Vanessa Allen, a microbiologist and infectious diseases specialist at the Public Health Ontario Laboratories where she and her colleagues tested drug responses from nearly 300 patients who were treated at a Toronto clinic.

The research, lead by Allen and published this week in the Journal of the American Medical Association, found that 7 per cent of the Toronto patients failed to respond to cefixime — the last commercially available oral drug for gonorrhea. Antibiotics are considered ineffective when the rate of failure exceeds five per cent.

Responding to Allen’s findings, Ontario is developing its first set of guidelines for treating the sexually transmitted infection that is becoming increasingly prevalent and increasingly difficult to cure with an oral antibiotic alone.

The guidelines, due for release in March, will advise clinicians to treat the infection with an intramuscular injection as well as an oral pill. The new guidelines are similar to those unveiled by the Centres for Disease Control and Prevention in the United States.

While antibiotics have been successfully used to treat gonorrhea for decades, the CDC reports the bacteria has grown resistant to every drug ever used to treat it, including sulfonamides, penicillin, tetracycline, fluoroquinolones and finally the last class on the market — cephalosporins. Resistance had already been detected in Asia and Europe.

As resistance grows so has the number of patients infected.

Cases of gonorrhea have doubled in Canada in the past decade. In Ontario, it is the second most frequently reported sexually transmitted infection behind chlamydia. More than 70 per cent of cases occur in people aged 15 to 29. Untreated gonorrhea in women can cause serious health problems, including pelvic inflammatory disease that can lead to infertility. In men, it can cause a painful testicular condition called epididymitis. In both sexes, an infected, untreated patient may face a greater risk of getting HIV.

Allen says it’s only a matter of time before the bacteria develop resistance to injections as well.

“It doesn’t bode well,” she said.

“It’s an international problem. I think there are a lot of very smart people who have been thinking about this for quite some time,” Allen added. “It’s an opportunity to cross borders and try to find a solution.”

From the Toronto Star:

Gonorrhea superbug resistant to cefixime, other antibiotics - thestar.com