A new strain of antibiotic-resistant gonorrhea has shown up in Hawaii, doctors reported Wednesday.
Seven patients infected with the new strain were treated and have recovered, but it’s an unwelcome confirmation that one of the most common sexually transmitted diseases (STDs) is gradually mutating into an impossible-to-treat form.
But there’s good news – an experimental new antibiotic seems to work as well as current drugs at curing everyday gonorrhea, offering a potential new drug to use against the infection.
The new, experimental drug is called ETX0914 or zoliflodacin. It’s in an entirely new class of drugs, working on bacteria in a way that no other drug does.
Gonorrhea was once easily treated with a quick pill, but it’s evolved into a form that resists the easy drugs. Now the recommended treatment is a shot of the antibiotic ceftriaxone along with azithromycin, the pill found in the popular “Z-pack.”
Dr. Alan Katz of the University of Hawaii and colleagues found the new gonorrhea superstrain as part of routine testing in Hawaii which, because it’s between Asia and the continental U.S., catches emerging new infections.
They found it in seven out of 25 people tested as part of routine monitoring. Careful testing showed the bacteria in each patient had similar mutations and were related, although the six men and one woman infected had no connection to one another.
“It is important for physicians to be on high alert,” Katz told reporters in a telephone briefing.
“Most people do not realize they have it. The only way they find out is through testing."
It’s not fully resistant – yet – and all seven people were cured by the standard regimen of ceftriaxone plus azithromycin. But in the lab, the gonorrhea bacteria showed the first signs of evolving resistance.
If people are infected with this strain and don’t get quick treatment, or the right treatment, it will evolve even faster and get passed around, Katz cautioned.
And another piece of bad news – people often don’t even know they have gonorrhea, or if they do and get inferior treatment, they may feel like they got better but still be incubating the resistant strain. That will mean people will need longer drug treatment with more injections and more pills.
“Most people do not realize they have it. The only way they find out is through testing,” said Dr. Gail Bolan, director of CDC’s Division of STD Prevention.
“When providers do not treat according to our recommendations and use a regimen they think will work, patients will feel better. Their symptoms will reduce but they will still have the organism.”
And they will still be able to spread it, silently, to others.