A closeup of gonorrhea bacteria.
BSIP UIG via Getty Images
By Sy Mukherjee
March 29, 2018

Public health officials have been sounding the alarm on increasingly difficult-to-treat strains of gonorrhea for years now. This week, health officials in the U.K. pointed to a tangible human case of “super gonorrhea,” drawing widespread concern among medical and infectious disease experts.

Public Health England succinctly sums up why this case is so alarming: “This is the first global report of N. gonorrhoeae with high-level resistance to azithromycin and resistance to ceftriaxone,” wrote the organization in a report.

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“We are investigating a case who has gonorrhea which was acquired abroad and is very resistant to the recommended first line treatment. First line treatment for gonorrhea is a combination of 2 antibiotics (azithromycin and ceftriaxone). This is the first time a case has displayed such high-level resistance to both of these drugs and to most other commonly used antibiotics,” added Dr. Gwenda Hughes, head of the Sexually Transmitted Infection (STI) section at Public Health England, in a statement. Public health experts said the threat presented by such superbugs is grave; David Harvey, executive director of the National Coalition of STD Directors, told CNN that “drug-resistant gonorrhea spreading around the globe” is among our “greatest” fears.

The case highlights the need to—and challenges of—developing new antibiotics as bacteria learn to survive the treatments. Gonorrhea is a particularly difficult infection because the bacteria that cause it “are particularly smart,” as the World Health Organization’s (WHO) Dr. Teodora Wi stated last July, when the agency warned of the rise of antibiotic-resistant gonorrhea. “Every time we use a new class of antibiotics to treat the infection, the bacteria evolve to resist them.”

At that time, there were just three new drug candidates for gonorrhea treatment in various stages of clinical development.

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