Increased Levels Of Antibiotic Resistance In Gonorrhoea, UK

Main Category: Sexual Health / STDs
Also Included In: MRSA / Drug Resistance;  Infectious Diseases / Bacteria / Viruses
Article Date: 14 Oct 2006 - 9:00 PDT

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New figures released today by the Health Protection Agency (UK) show that levels of antibiotic resistance in gonorrhoea, the second most common bacterial sexually transmitted infection, continue to increase.

The figures from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) show that levels of resistance to cirprofloxacin have increased from 14% in 2004 to 21.7% in 2005 and resistance to penicillin has increased from 11.4% in 2004 to 17.9% in 2005.

The levels of resistance remained relatively stable in women from 5.2% in 2004 to 6.3% in 2005 and heterosexual men from 10.3% in 2004 to 11.8% in 2005. However, the prevalence significantly increased in homosexual men from 26.2% in 2004 to 42.4% in 2005.

Professor Catherine Ison who led this research for the Agency said: "This increasing resistance to penicillin and ciprofloxacin is concerning and highlights the need for anyone who is infected to be treated with the recommended therapy, ceftriaxone or cefixime. The recommendation for treatment with cephalosporin antibiotics was made in 2002 when information from this programme showed that resistance was increasing to fluoroquinolone antibiotics such as ciprofloxacin. Ceftriaxone or cefixime should be used unless laboratory testing has shown that other antibiotics such as ciprofloxacin or penicillin will be effective.

It is vital that those who have symptoms of gonorrhoea and may be infected seek treatment at either specialised Sexual Health Clinics (Genitourinary Medicine Clinics) or contact their GP . A total of 18,483 cases of gonorrhoea were diagnosed in England and Wales in GUM clinics during 2005.

When treating patients with gonorrhoea, doctors should be reassured that no treatment failures have been documented with the recommended cephalosporins, ceftriaxone or cefixime. However if a patients' infection does not seem to be clearing up then they should submit samples to a laboratory for antibiotic resistance testing.

"The rise in antibiotic resistance and the fact that gonorrhoea infection can occur with no symptoms makes it a major public health concern. These figures show that resistant infections appear to be concentrated among gay men as well as being more commonly associated with factors such as individuals having sex abroad.

"These figures reinforce the importance of using condoms with new and casual partners to avoid the transmission of sexually transmitted infections (STIs). If you think you may have put yourself at risk of contracting a sexually transmitted infection it is always best to seek advice from your local Genitourinary Medicine Clinic."

GRASP has proven to be a successful collaboration, with N. gonorrhoeae samples obtained from 24 laboratories and 26 GUM clinics collecting data on over 13 000 isolates over six years. The data have allowed the Health Protection Agency (HPA), to determine annual antimicrobial susceptibility patterns of N. gonorrhoeae in England and Wales over time. they have enabled the HPA to characterize the demographic and behavioural characteristics of patients with infections caused by antibiotic resistant gonococci and have informed the national treatment guidelines.

Gonorrhoea can appear with no symptoms, leaving people unaware of their infection. If symptoms occur in women they can include a painful and burning sensation when passing urine or discharge from the vagina that is yellow or bloody. These symptoms will occur within 2-10 days of becoming infected. Men more frequently present with symptoms which can include a discharge from the penis and a severe burning pain when passing urine.

If left untreated gonorrhoea can lead to complications such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy or infertility. Infection during pregnancy may lead to spontaneous abortion, stillbirth or neonatal complications.

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