Super Gonorrhea: New Epidemic Feared as a Sexually Transmitted Infection Shows Total Resistance to Antibiotics

In December 2019, the Chinese city of Wuhan was pinpointed as the ground zero for the COVID-19 pandemic. After more than four years, China may be fueling a global rise in a new infectious disease.

A Looming Epidemic

The world is on the verge of a new epidemic called super gonorrhea. A recent study reveals a 98% resistance rate to antibiotics among those treated for the sexually transmitted infection.

Antibiotic resistance has been a growing health concern for years, but the ability of the current strain to evade medication is troubling. China reports a dramatic rise of a strain of gonorrhea which is resistant to one of the last remaining effective antibiotics at a rate 40 times higher than in the US, Canada, and UK.

Conducted by the US Centers for Disease Control and Prevention (CDC), the study has sounded the alarm about the disastrous situation. It highlights the ineffectiveness of standard treatments like cefixime, azithromycin, and ciprofloxacin in fighting the super gonorrhea strain.

Led by Xiaoyu Zhu, the research team collected more than 2,800 bacteria samples in 2022. These samples showed 97% resistance to ciprofloxacin and 78% resistance to penicillin. Moreover, about 17% showed resistance to cefixime and azithromycin, while 8% were found to be immune to ceftriaxone, the current standard treatment.

In China, the percentage of strains resistant to ceftriaxone has significantly risen, reaching 8.1% compared to much lower rates in other countries. Meanwhile, the US and Canada have much lower rates of resistance to ceftriaxone, reported as 0.2% and 0.6%, respectively.

Study authors suggest that effective diagnosis and treatment, along with appropriate management of sex partners, are important in protecting the health of infected persons and in preventing ongoing transmission of gonorrhea. Public health practitioners are expected to prioritize assessment of screening practices, especially in regions with higher rates of gonorrhea cases and resistance rates.

Transmission and Prevention of Gonorrhea

Gonorrhea is an infection which can be spread through sexual contact with the vagina, penis, mouth or anus of an infected partner. It can also be spread perinatally from mother to baby during childbirth. In most cases, gonorrhea is not a deadly condition but if left untreated, it can become a more severe inflammatory issue leading to pelvic pain and even infertility.

Historically, penicillin used to be the first-line treatment against this sexually transmitted infection, but its use has dropped off due to widespread resistance. Then, ciprofloxacin and other fluoroquinolones took its place, until they were also rendered ineffective when resistance became more widespread.

Currently, ceftriaxone serves as the go-to treatment. However, it may also need to be replaced by another in the near future given the pace at which strains can mutate and overcome certain medications. The widespread resistance may also require developing a totally new drug.

Throughout the world, all types of antibiotic-resistance infections lead to around 700,000 annual deaths. This figure is expected to rise to 10 million annual deaths by 2050 if no intervention is developed.As antibiotic resistance rises globally, urgent action is needed to address this growing public health threat.