A new super-strain of gonorrhea that is resistant to 5 antibiotics has been detected in US patients, health officials say

Andrea Michelson
Fri, January 20, 2023 

A billboard from the AIDS Healthcare Foundation warning of drug-resistant Gonorrhea in Hollywood, California on May 29, 2018.Frederic Brown/AFP via Getty Images

• Two patients in Massachusetts caught a new multi-drug-resistant strain of gonorrhea.

• The patients recovered, but the bacteria was resistant to several antibiotics.

• Gonorrhea is the second most common STI in the US — and it's on the rise.

Health officials are on alert since a new strain of gonorrhea was detected this week in Massachusetts that is showing signs of resistance or reduced susceptibility to all drugs that are recommended for treatment.

Two apparently unrelated cases of gonorrhea were either resistant to treatment, or harder than usual to treat, with five classes of antibiotics according to a press release from the state health department.

Although both cases were eventually cured with ceftriaxone — the antibiotic that's currently recommended to treat gonorrhea — the bacteria was not as susceptible to the medication as usual, according to an alert the Massachusetts Department of Public Health sent to clinicians. In other words, it put up a fight.

This is the first time that a strain of gonorrhea in the US has displayed resistance or reduced response to not just one, but seven different drugs across five classes of antibiotics, the clinician's alert reported. Two other medications from the same class as ceftriaxone also showed reduced efficacy in lab tests, along with four unrelated antibiotics.

Gonorrhea is on the rise in the US 

While there used to be several options available to treat gonorrhea, the pool of drugs that can successfully stop the infection is shrinking — just as infections are increasing in the US. New cases of gonorrhea increased 10% by the end of 2020 compared to the year before, according to the CDC. Overall, gonorrhea cases have increased 131% since 2009, and it has become the second-most common sexually-transmitted infection in the US.

The disease often has no symptoms, but when symptoms are present they may include a burning sensation when peeing; unusual discharge from the penis or vagina; and bleeding between periods, according to the CDC. These symptoms can also indicate another STI, such as chlamydia.

Gonorrhea has already evolved resistance to some antibiotics

Back in the 1990s, there were a few different antibiotics that were prescribed to treat gonorrhea. Infected patients had the choice of ceftriaxone or cefixime — both cephalosporins — or ciprofloxacin, which comes from a different class of medication.

However, strains of gonorrhea that were resistant to ciprofloxacin soon appeared to circulate in Hawaii and on the West Coast, according to the CDC. The agency stopped recommending the drug as a gonorrhea treatment in 2007.

Now, public health officials fear that our best existing treatment for gonorrhea could meet the same fate.

"The discovery of this strain of gonorrhea is a serious public health concern which DPH, the CDC, and other health departments have been vigilant about detecting," Margret Cooke, head of the Massachusetts Department of Public Health, said in a statement Thursday.

Genetic sequencing revealed the strain had a marker for reduced susceptibility to ceftriaxone, but it is not yet clear how far the strain has spread. According to the alert sent to clinicians in Massachusetts, eight cases of the same sequence type have been identified in the UK between December 2021 and June 2022, and some cases have also been seen in Asia.