World in a losing battle with gonorrhea as it continues to evolve

Posted Jul 7, 2017 by Karen Graham
Gonorrhea, commonly called "the clap" or "the drip." is now more prevalent globally and harder to treat than ever before, according to the World Health Organization, with some strains of the sexually transmitted disease impossible to treat.
This illustration depicts a Gram-stain of a urethral exudate showing typical intracellular gram-nega...
This illustration depicts a Gram-stain of a urethral exudate showing typical intracellular gram-negative diplococci, and pleomorphic extracellular gram-negative organisms, which is diagnostic for gonococcal urethritis.
CDC/ Dr. Norman Jacobs
An estimated 78 million people are diagnosed with gonorrhea every year around the globe. This sexually transmitted disease can be transmitted via oral, anal or vaginal sexual contact, infecting the genitals, rectum or throat. And the really worrisome problem with these statistics is that the numbers are probably higher because of unreported cases.
But despite people being warned about the gonorrheal bacteria becoming resistant to commonly used antibiotics, the number of cases has continued to rise, helped along by a drop in condom use, increased travel, urbanization. and low infection detection rates in many countries.
And as the STD becomes more widespread, gonorrhea continues to be smart, constantly evolving to become resistant to every antibiotic we use to battle the disease. But here's something surprising - Health officials have found that untreatable gonorrhea infections are more prevalent in higher-income countries, perhaps because of better surveillance.
This case of gonorrheal conjunctivitis resulted in partial blindness due to the spread of N. gonorrh...
This case of gonorrheal conjunctivitis resulted in partial blindness due to the spread of N. gonorrhoeae bacteria.
“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, reports Newsweek.
“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.”
According to the WHO report, "97 percent of countries report gonorrhea that resists ciprofloxacin, 81 percent have found cases that resist azithromycin and two-thirds of countries have found strains that resist the last-resort drugs: extended-spectrum cephalosporins (ESCs) such as oral cefixime or injectable ceftriaxone."
Research and Development on new drugs needed
According to the WHO, the cupboard is nearly bare when it comes to any new drug candidates. There are three in different stages of R&D development, including solithromycin, for which a phase III trial has recently been completed; zoliflodacin, which has completed a phase II trial; and gepotidacin, which has also completed a phase II trial.
The problem is that most pharmaceutical companies don't see any profit in creating new antibiotics, especially those that will only be used for a short time to cure an illness. But with the growing resistance to commonly used antibiotics by so many bacterial strains, it has become an almost emergency situation that needs to be addressed.
The Drugs for Neglected Diseases initiative (DNDi) and WHO have launched the Global Antibiotic Research and Development Partnership (GARDP). GARDP's primary mission is to develop new antibiotics and most importantly, stress their appropriate use so they can maintain their effectiveness for as long as possible.
"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 Dr. Marc Sprenger, Director of Antimicrobial Resistance at WHO.