In Austria, researchers have identified a strain of bacteria that causes gonorrhea and is resistant to many different antibiotics. A man contracted it while having unprotected sex in Cambodia.
For the second time, researchers around the world have identified a multiply resistant gonococcal strain. The bacteria lead to what is known as gonorrhea, a sexually transmitted disease that is also known colloquially as “gonorrhea”. The variant detected in April comes from a traveler returning from Cambodia, writes the research team led by Sonja Pleininger from the Austrian Agency for Health and Food Safety (AGES) in the publication in the specialist journal “Eurosurveillance”. The man had sex without a condom with a prostitute in Cambodia five days before the symptoms began.
The infection is caused by the bacteria. The pathogens Neisseria gonorrhoeae primarily attack the mucous membranes. Men then experience itching and discharge of purulent secretions from the urethra. They also feel pain when urinating, but an asymptomatic or mild course, as in many infected women, is very rare in men.
Nevertheless, every infection should be treated, otherwise consequential damage such as inflammation of the joints, changes in the skin or even heart valve or meningitis can occur. In women, infertility or life-threatening inflammation in the pelvis are also possible as consequential damage. In pregnant women, it can lead to malformations in the unborn child. If the disease is not treated, it can also spread further.
The bacterial infection is usually treatable with certain antibiotics. In the current case, the standard therapy initially failed. Although the man was better, the tests remained positive.
The pathogen Neisseria gonorrhoeae was then examined more closely. He showed up in the laboratory with high resistance to azithromycin. Resistance to ceftriaxone, cefixime, cefotaxime, ciprofloxacin and tetracycline, all antibiotic agents used in gonorrhea, has also been identified. The multiple resistances not only make it difficult to treat the patient, they also make the pathogen a dangerous “super gonorrhea”.
The pathogen has already shown itself to be changeable in the past. There are now a number of mutations that are resistant to many of the drugs that have been used successfully to date. In the treatment, physicians currently rely primarily on the administration of ceftriaxone, which is often prescribed in combination with azithromycin. In recent years, resistance to azithromycin has increased rapidly in Europe. In addition, several ceftriaxone-resistant strains have been identified in several European countries, the scientists emphasized.
The researchers emphasize that if new offspring are now circulating that may be better protected against all available therapy options, they should be viewed as a greater risk to public health. In the worst case, the infection can no longer be treated in the future. This danger must be countered with measures such as the use of condoms, rapid diagnosis and easily accessible, effective and inexpensive treatment options.
The man was eventually cured with a combination antibiotic regimen given twice a day for a week. However, the Cambodian sex worker could not be located. The experts fear that other people could become infected with the resistant pathogen.
In order to prevent further infections and the formation of multi-resistant pathogens, the experts are calling on the authorities, especially in Asia, to activate and intensify the surveillance systems. The first multidrug-resistant gonorrhea pathogen was detected in a man in the UK in 2018. He, too, was most likely infected during a stay in Asia. In response to the growing number of resistant Neisseria gonorrhoeae pathogens, the Robert Koch Institute (RKI) introduced a laboratory reporting obligation for resistant pathogens as early as 2020.