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Dr Jane Ashby, Consultant in Sexual Health and HIV at The Physicians’ Clinic, comments on the 'world’s worst super gonorrhoea'

May 31, 2018

http://www.bbc.co.uk/news/health-43840505

This week the BBC published an article about the 'world's worst super gonorrhoea'. The article relates to a man who is thought to have contracted this highly resistant strain of Gonorrhoea during sex with a woman earlier this year in South East Asia. What is notable about this case is the very extensive antibiotic resistance that the strain carried, meaning that the usual treatment consisting of a combination of injection and tablets, failed to treat the infection. In fact, almost every antibiotic that we have available for use, would be useless on this type of gonorrhoea, effectively rendering it almost untreatable. It's a sobering thought, one that for some time now has been worrying experts - a kind of bacterial doomsday. Thankfully this case was identified quickly and it seems unlikely that in this case the strain has been passed on within the UK...for now. Worryingly, 2 further cases of this multi drug resistant gonorrhoea have subsequently been reported in Australia, demonstrating clearly the effects of travel and globalisation and the lack of protection afforded by borders and geography when it comes to infectious agents.

Gonorrhoea is a bacteria spread during sexual contact and in recent years in the UK the rates of gonorrhoea diagnoses have been increasing1 (fig 1). Various symptoms can occur including discharge from the vagina, penis or anus. In both men and women, gonorrhoea can cause inflammation within the genital tract that can lead to longer term issues including fertility problems. For many people however, there are no symptoms and the infection can go undetected and untreated unless testing is performed. Diagnostic tests have improved in recent years and are now fast, accurate and pain free. Usually Gonorrhoea can be cured with antibiotic treatment, but if the test isn't performed then the infection can remain undetected and untreated.

Timely screening of people at risk of infection and treatment of contacts of infections, as well as judicious use of targeted antibiotics and the development of new ways to treat gonorrhoea are all urgently needed to stem the rise of multi drug resistant gonorrhoea globally.

Figure 1

world's-worst-super-gonorrhoea.jpg

Reference
1. Public health STI data set 2016. https://app.box.com/s/rlnlh9tmip29dew9erk12zyizzdv99vm/file/255603915576

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