Gonorrhea Getting Smarter: Bacteria Is Evolving to Become 'Impossible to Treat,' WHO Warns

Neisseria gonorrhoeae Bacteria, which causes gonorrhea. NIAID

Newly evolved strains of drug-resistant gonorrhea are making the sexually transmitted infection impossible to treat, the World Health Organization has warned.

become impossible to treat, with the bacteria becoming resistant to all the drugs used to combat the sexually transmitted infection, the World Health Organization has warned.

An estimated 78 million people are infected with gonorrhea every year, which can be transmitted via oral, anal and vaginal sex and can infect the genitals, rectum and throat, meaning it In new analysis of data from 77 countries, researchers have discovered antibiotic resistance is making gonorrhea far more difficult, and in some cases impossible to treat.

Resistance to drugs traditionally used to treat gonorrhea was found to be widespread. Untreatable infections were found to be more prevalent in high income countries, where surveillance is higher.

"These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhea is actually more common," said Teodora Wi, Medical, from the WHO.

"The bacteria that cause gonorrhea are particularly smart. Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them."

A drop in condom use, increased travel and urbanization and low infection detection rates, combined with inadequate and failed treatment appear to be behind the rise in drug resistant gonorrhea, the WHO said.

The findings from the latest report show how resistance to the "current last resort treatment" has been reported in over 50 countries. As a result, the WHO is advising doctors to treat gonorrhea with two antibiotics— ceftriaxone and azithromycin.

But this solution will not last, it adds. The pipeline for new gonorrhea drugs is "relatively empty," with just three new drugs in development: "To address the pressing need for new treatments for gonorrhea, we urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline," said Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership (GARDP), an initiative recently launched by the WHO.

"In the short term, we aim to accelerate the development and introduction of at least one of these pipeline drugs, and will evaluate the possible development of combination treatments for public health use. Any new treatment developed should be accessible to everyone who needs it, while ensuring it's used appropriately, so that drug resistance is slowed as much as possible."

In the meantime, the WHO says prevention is a key course of action. This includes using condoms, improved awareness of the symptoms of gonorrhea and campaigns to reduce stigma around STIs. "To control gonorrhea, we need new tools and systems for better prevention, treatment, earlier diagnosis, and more complete tracking and reporting of new infections, antibiotic use, resistance and treatment failures," said Marc Sprenger, Director of Antimicrobial Resistance at WHO.